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SIM11we""'In mon • 1 ` • 1 • • i • <br /> ll& <br /> ncaster <br /> U —IDA—IDAIS W� 2282 For Lancaster Laboratories use only <br /> Please phrintint -1 a9 IL'gt1d1/fjiaSC Acct.#: Group#!�a1 a$5aSample#: J�`J 1`7 <br /> 1/ Analyses Requested SCR#: <br /> SitelGlobal ID: Lt' f ` Preservation Codes Preservative Codes <br /> Site Address: lug✓, H= HCI T=Thiosulfate <br /> N= HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC d S=H2SO4 O=Other <br /> in <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 <br /> ❑J value reporting needed <br /> K3800 Watt Avenue,Suite 210,Sacramento,CA 95821 a <br /> z HPP Risk Assessment Detection <br /> Consultant Prj.Mgr.:_ Q fly U ❑ El _jw0 <br /> imits <br /> Consultant Phone#: ' 7 ° o o ❑ W W X �, ❑Chromatograms <br /> Fax#: y co CO _� 0 o U <br /> Sampler: 2 ❑ ❑ 0 0 0 0 2 <br /> rn 7 '0 m o M M = ¢ <br /> Q Z co m m u t2 c N <br /> Field Repeat ToP Time New o � >< m = _ _CD CD = a <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Fn r 0 L) 9 m aLu <br /> �y 5 0 <br /> ' X Comments!Remarks <br /> ) 5' <br /> �J X =r (!JE'fi�tBS vz� <br /> !U - 517 W 1705 AfW <br /> Id 1 ofTAP!d <br /> eta <br /> Turnaround Time Requested(TAT)(check box) Reli fished by: Date Time Received by: (' Date Time <br /> STD.TAT ❑ 24 hour ❑ 48 hour 700 !7�— <br /> ❑ 5 day ❑ 72 hour 114 day a inq fish Date Time Received by Date Time <br /> Matrix Values Repeat Values Relinquished by: 1 Date Time eiv d by: ate Time <br /> S Soil D Duplicate sample <br /> W Surface Water or Groundwater T Triplicate Sample Relinquished by rcial Carrier: Recei d to : 1 Date Time <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS Fe x— Other J <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt 3 oc3 pH Cus dy Seals Intact? es No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1/14105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />