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'tlCh <br /> Historical-Yiplefthe PonYofid AnolysisRe1 1 1 Clistody <br /> Uxaster Laboratories 2 2 9 a For Lancaster <br /> /Laboratories use only _ 2 <br /> +WhereCCra�tyts a 5GtenCe. Acct.#: "1 Group# 1 0[U`1 iJ' Sample#: 5!3 1 544 a �3 <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: Alicn c i, SL��j l� d Preservation Codes Preservative Codes <br /> Site Address: G <br /> �� C_y C� H =HCI T=Thiosul#ate <br /> a N =HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SACC ill S=H2SO4 O =Other <br /> rn U <br /> Cons ultantlOf€ce: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 c� ^' ❑J value reporting needed <br /> r,v3800 Watt Avenue,Suite 210 acramento,CA 95821 z PP Risk Assessment Detection <br /> -�� L its <br /> Consultant Pd.Mgr.: I h0 �-9 v�'`1 5 ❑ O -' 0 ❑Chromato rams <br /> Consultant Phone#: �l ` 37-4`6 Fa #: <?16 -� m co co 0 o g <br /> Sampler: !'t��iccc� �, +�y+ �. o o g M M <br /> Z m � o v <br /> Uj co co <br /> Field Repeat Top Time New CL 00 <br /> o o W m _ _ = = ~ <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN c) H m a <br /> O 11( j$7 Colm�ments I Remarks <br /> !! <br /> 0 <br /> Turnaround Time Requested(TAT)(check box) Relinquishe Date Time Received by: D to Time <br /> TD.TAT ❑ 24 hour El 48 hour ///, /� ,4 116 <br /> 5 day ❑ 72 hour ❑4 day Relinquished by: Date Time ftzeiv%d4X: Date Time <br /> Matrix Values Repeat Values Relinquished by: ate Time Received by: Date Time <br /> SbSoil D Duplicate sample Relinquished mercial Carrier: Received by'. Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS Fed Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt C° pH Custody teals Intact? Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />