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u btiuChesapeakeDrive•Redwood City CA 9401 )364 9600 ❑ 18939 1201h Ave,N E,Suite 101 •Bothell WA 98011 • 1 9200 <br /> U N� n L (DU 819 Striker Ave 5uile 8.5acramonto,CA 9583 �o)921 9600 U East 11 115 Montgomery Suite B•Spokane WA 99206•(509)924 9200 <br /> /"� U 404 N Wiget Lane•Walnut Creek,CA 94598•(510)9BB 9600 U 15055 S W Sequoia Pkwy Suite 110•Portland OR 97222•(503)624 9800 <br /> Consultant Company S C_0 2 Project Name C, r c f Q Kfa►� a, $6 7 j <br /> Address 9 r<a U tG�'n e s 5 P.r kfl r; v S u fir /Q d UNOCAL Project Manager <br /> CitySa C r 4 n,C ti f p State 611 Zlp Code cl S$a`7 AFE # <br /> 5e c EAE <br /> Telephone �l 36 �� l FAX # (9l6 3Cy- C S Site #, Ctly, Stafe r�.r^gyp r, Av'^`'z m <br /> Report To Re S+ Ben ko Sampler 7�,/ Q r a w QC Data fA Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround IJ 10 Work Days IJ 5 Work Days 1:13 Work DaC <br /> ys <br /> IJ Drinking Water Anal ses Re nested <br /> Time IJ 2 Work Das Pi i Work Day IJ 2 8 Hours IJ Waste Water <br /> CODE IJ Misc IJ Detect lval IJ Remed U Demol IJ Closure l< Other <br /> Client Date/Time Matrix # of Conl Laboratory <br /> Sample I D Sampled Desc Conl Type Sample_ # Comments <br /> 1 P� - f sli-9g �� as So, l l Brass �`�C )3? oe X <br /> 2 PL, -�1-78 l��a q I <br /> to <br /> 3 PL -3 <br /> 4 5 w I -VFS - () x o <br /> 5 1A <br /> oq <br /> 05 <br /> G -I 9-4-A )2:02 <br /> s N <br /> 10 <br /> o <br /> a <br /> C <br /> Relinquished By Date � /-p Time /S � Received :7 Da�/ TimeJ <br /> �— 15��.� ,-- � <br /> Relinquished By L <br /> -c.E� Date S Time 73v Received B pate Time <br /> Reline unshed B }' <br /> Dale T1meReceived By Lab Date ) Time <br /> 17 <br /> Were Samples Received in Good Condition <br /> 9(1Yes 1-1 No Samples on Ice?(WYes(A No Method of Shipment -5��r�U f <br /> p � Page J_of 1 <br /> To be completed upon receipt o report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes 1,No If no, what analyses are still needed? <br /> 2) Was (lie repair issued within the requested turnaround time? t-f Yes U No If no, what was the turnaround times _T <br /> Approved by Signature Company _ Date - -- <br />