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❑ 680 Chesapeake Drive • Redwood City, CA 94063 • (415) 364-9600 ❑ 111111 111h Ave., N.E., Suite 101 • Bothell, WA 98011 • (206) 481-9200 ® LJ 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 Ll East 11115 Montgomery, Suite B • Spokape, WA 99206 • (509) 924-9200 'CAL Ll 1900 Bates Ave., Suite LM • Concord, CA 94520 • (510) 686-9600 ❑ 15055 S.W. Sequoia Pkwy, Suite 110 • Portland, OR 97222 • (503) 624-9800 Company Name: k yr `y,F o� Date: Project Name: '�v� �,_ �, , Address: L, CiuP, I�G�4, r" 1 Were Samples Received in Good Condition9 UNOCAL Project Manager: ur�Sio City:,. ', ,� ,,v State: /Yes ❑ N Zip Code: ,� b ;: �o Release #: Telephone: 6.5�� - 0 8.� FAX #: 6,31k — r=s Yas- Site #: Re ort To: �,.. c -ll, Sampler: Ri c�G gc QC Data: Level D (Standard) ❑ Level C ❑ Level B ❑ Level A Turnaround ❑ 10 Work Days 5 Work Days ❑ 3 Work Days ❑ Drinking Water Anal ses Requested Time: ❑ 2 Work Das ❑ 1 Work D'ay ❑ 2-8 Hours ❑ Waste Water CODE: ❑ misc.IKDetect. ❑ Eval. ❑ Remed. ❑ Demol. ❑ Closure ❑ Other Client Date/Time Sample I.D. Sampled Matrix Desc. # of Cont. Cont. Type Laboratory � Sample # AN � Comments 1.-1-INVJ-1 7L2115 7:ya s®; 1 r k a 2. -1— rq ®q H5 3. -4 SW -4H59? 4. _ -SE-q 6 Oy 5. 6. _ 7 HW_ S s 9. _Z -.SE-2's 10. -2— C- 9.5 12:1 Relinquished By: Relinquished By: 1� Received By: Relin uished B Date: Time: ReceivedKv I�G�4, r" 1 Were Samples Received in Good Condition9 Yes L-1 No Samples on Ice? /Yes ❑ N Method of Shipment 12 To be completed upon receipt of report: 1) Were the analyses requested on the Chain of Custody reported? ❑ Yes ❑ No If no, what analyses are still needed? 2) Was the report issued within the requested turnaround time? 0 Yes ❑ No If no, what was the turnaround time? Approved by: Signature: Company: me: 2' S � Time: 1"V ' 5J ?LIC112 Page _Z of 1 Date: