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y, t0k4IJ J04Jouu a luVJU 3zurnAve,N!_,buile IUi •1$oihell,WA 98011 481-92OU <br /> UNaVAL (DU 819 Striker Ave,Surte 8•Sacramento,CA 95816)921 9600 U East 11115 Montgomery,Suite 8•Spokane,WA 99206. 9249200 i <br /> Q 404 N Wigel Lane•Wainut Creek,CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 <br /> Consutlant Company p Y Ftr"CJQL?,o�,JN-LOVI'L CtfW Protect Name <br /> Address,�sS- S� UNOCAL Protect Manager <br /> City State CA Zip Code Af=E # <br /> Telephone ( �qzrr� FAX If r ��j Site #, City, State d2z C� m <br /> U <br /> Report To t 0991A 1QWG Sampler C�W r� QC Data A-level D (Standard) ❑ Levet C ❑ Level B ❑ Level A <br /> Turnaround Jap Work Days ❑ 5 Work Days ❑ 3 Work Days U Drinking Water lAnalyses Requested 12- <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE' ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix If of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> pkv <br /> 2 C-- - ,� b2 y 0 <br /> 0 <br /> 3 � <br /> 4 � <br /> 0 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 Z' <br /> 0 <br /> ro <br /> 0 <br /> Relinquished By Datel_0 115P Time Q Received By Date Time -' <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition?a Yes❑ No Samples on Ice? i]Yes Ct No Method of Shipment Page_of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Cham of Custody reported? Q Yes(J No If no, what analyses are stili needed? <br /> 2) Was the report Issued within the requested turnaround time? lJ Yes IJ No If no, what was the turnaround time? <br /> Approved by _ -Signature ------Company Date <br />