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680 Chesapeake Drive•Redwood City,CA 940 3•(415)364-9600 O 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011• 6)481-9200 <br /> UN*C A L f O 819 Striker Ave,Suite 8•Sacramento CA 95(916)921-9600 ❑ East 11115 Montgomery,Suite 8•Spokane,WA 99206)924-9200 . <br /> ❑ 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 © 15055 S W Sequcma Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company C�t� 1�_ P'Stia, r , �'�� #2Sooar-y Project Name r-iQLe V1 c,. SS •2 S 5 <br /> Address q + UNOCAL Project Manager + u <br /> City State C Zip Code Ysb AFE # <br /> c <br /> Telephone <br /> p �5 1- �y S S` FAX# °�za-S -/- '�� 4 Site#, City, State v <br /> Re ort To Sam ler ✓tt�71�•1�c1 QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A C <br /> Turnaround 10 Work Das ❑ ork Das ❑ 3 Work Da <br /> Y Y Ys ❑ Drinking Water JAnalyses Requested] f�3 <br /> Trine 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours A Waste Water <br /> CODE: ❑ Mlsc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont Laboratory \� <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 0 <br /> t4W-1 ti rZ' o Jois -t z <br /> Y <br /> 4 h W� 3 zzv Ph 4 `� �' X o <br /> 5 NW— <br /> 7'!W x/z '*S-1 Y 4i X 4 <br /> a M � » /0 ��> S K- <br /> --------------- <br /> � <br /> L <br /> 0 <br /> p <br /> Relinquished By IVA ` Date ! Time eceived B J <br /> Date Time , <br /> m <br /> Relinquished By Date Time Tre-c'eived By Date Time <br /> Relinquished By Time Received B Lab J-4M oOVWYj) I Date I/l/9F ITime 0-3s <br /> Were Samples Received in Good Condition?�Yes 0 No Samples on lee? (XYes LISTNo Method of Shipment CPage—ofTo a competed upon receipt o report <br /> 1) Were the analyses requested on the Chain of Custody reported? 0 Yes U No If no, what analyses are still needed? <br /> 2) Was the report tssued within the requested turnaround time? ❑Yes❑ No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />