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)a-*WGhesepeakeUrlve•Iledwood Ufly,GA 9 (41S)364 9600 U 18939120111 Ave,N E,Suite 101 •Botlielf,WA 911011 <br /> UNOtAL <br /> ! U 619 Striker Ave, Suite 8•Sacramento,CA 934•(916)921-9600 U East 11115 Montgomery,Sui <br /> le B e Spokane WA 99206•(509)924-920 <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 0 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Company Name %�- Erb Protect NameS'0,2'40 <br /> Address �A <br /> �� �� -0 UNOCAL Protect Manager 'J�Dp� � <br /> City -- ', rr�rr rr State (CA Zip Code Release# <br /> Telephone �L"t - FAX# [- _ , Site# 2�5SI G(ftf-7 L 131, <br /> Report ToK v <br /> Sam ler , <br /> � � Ab QC Data evel D(Standard) ❑ Level C ❑ Level B ❑ Level A C <br /> Turnaround.6 10 Work Days ❑ 5 Work Days ❑ 3 Work Days <br /> ❑ Drinking Water Anal ses Request <br /> a <br /> Time. ❑ 2 Work Das ❑ 1 Work Da 02-81-fours <br /> ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval 'X'-"Remed ❑ Demol ❑ C16sure her <br /> Client Date/Time Matrix #of Cont <br /> Sample I D Sampled Desc Cont Type Sample Laboratory <br /> # `` <br /> p Comments <br /> 7?k—�/'c L'_ <br /> 0 <br /> 3 A <br /> 4 , <br /> 5 <br /> 30 a1 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 0 <br /> c�a <br /> 0 <br /> Relinquished ayDate , ,� Time Received B co <br /> Date 3 ��Time _ --1 <br /> Relinquished By Date ' <br /> Time lI Y5 Received B Date ime <br /> Relinquished B r,. ,, � � � <br /> Dat f Time Received B Lab `( f/ Date 5-kA6 Time r <br /> Were Samples Receive in Goo Condition?❑Yes❑No Samples on Ice? ❑Yes No Method of Shipment pa <br /> of <br /> Page To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑No If no, what was the turnaround time? <br /> Approved by Signature Company <br /> _ _ Date <br />