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Q 680 Chesapeake Dnve•Redwood City CA 94 415)364 9600 Q 18939 120th Ave N E,Suite 101 •Bothell WA 98011 •081 9200 <br /> Q 819 Striker Ave,Su:te 8•Sacramento CA 95834•(916)921 9600 Q East 11115 Montgomery,Suite B•Spokane,WA 99206-(509)924 9200 <br /> N, UNeCAL (D ❑ 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> v <br /> Consultant Company 6 F c D iL Project Name <br /> ac on <br /> Address D J S ,i e 55 r 1< )D ; tl Su e r�o UNOCAL Project Manager C If/ 9d.f Sto .� <br /> City ,C r-a r,,en o State C Zip Code 'TT-9.27 AFE # G 16 3 <br /> Telephone 9l� �6 - C'�8o FAX # 0l6 39 Site #, City, State <br /> U <br /> Re ort To Fos de, 169Kr iSamplera�cd 8� ,,� QC Data Level D (standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround 1:110 Work Days 1:15 Work Days ❑ 3 Work Days Drinking Water [Analyses Re uesetd l <br /> Time ❑ 2 Work Das IN 1 Work Day ❑ 2-8 Hours ❑ Waste Water �(b QO <br /> CODE ❑ Misc ❑ Detect Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client DatefTime Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# e Comments <br /> _T12 4 v 2 i 1 8�n�s '� � � X o 0 <br /> 2 5 P 2 -18 9��iy'r�s 1 ? co� <br /> 5 j <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 0 <br /> L <br /> 0 <br /> Relinquished By / Date Time /S/ Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished B Date Time R ve L f' r l� G,�I Date' � Time /� 0 <br /> Were Samples Received In Good Condition?❑Yes O No Samples on Ice Yes Q No Method of Shipment Page of—{ <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes Q 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 _� T T_ ____-Company - __--___--- Date <br />