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❑ 680 Chesapeake Drive • Redwood City, CA 94063 • (415) 364-9600 ❑ 18939 120th Ave., N.E., Suite 101 • Bothell, WA 9801.1 • (206) 481-9200 <br />UN00"Ho 0;'-A L® 5*18'19 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 ❑ East 11115 Montgomery, Suite B • Spokane, WA 99206 • (509) 924-9200 <br />❑ 1900 Bates Ave., Suite LM • Concord, CA 94520 • (510) 686-9600 ❑ 15055 S.W. Sequoia Pkwy, Suite 110 • Portland, OR 97222 • (503) 624-9800 <br />Company Name:�� <br />Date: s--Ir-S7 <br />Time: /DSD <br />Received <br />Project Name: <br />Time: <br />�O <br />Date:S/ 7 <br />Time: 20 <br />Address: &6 <br />U <br />Time: <br />UNOCAL Project Manager: <br />��V� <br />Cl.9a�arir <br />1 Date /519 <br />Lime: <br />City: ,v04,;, ,a State: ,y <br />Zip Code: <br />70 <br />Release #: <br />Telephone: /C.-) 651 -ac -r-) <br />FAX #: �, <br />/s e3/ Z <br />Site #: <br />Re ort To: ,ecc ISameler: <br />QC Data: Level D (Standard) ❑ Level C <br />❑ Level B <br />❑ Level A <br />Turnaround ❑ 10 Work Days 5 Work Days ❑ 3 Work Days <br />❑ <br />Drinking Water <br />[Analyses Re <br />uested <br />Time: ❑ 2 Work Das ❑ 1 Work Da <br />❑ 2-8 Hours <br />❑ <br />Waste Water <br />CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demol. ❑ Closure ❑ <br />Other <br />Client Date/Time Matrix <br />Sample I.D. Sampled Desc. <br /># of Cont. <br />Type <br />Laboratory <br />�\ <br />Q�y� <br />Cb� <br />Cont. <br />Sample <br /># it <br />��~OCA <br />Comments <br />3. <br />4. <br />5. <br />'00,710 A- <br />6. <br />7. <br />8. <br />9. <br />10. <br />Relinquished By: <br />Relinquished B . <br />Relin uished B <br />Were Samples Received in Good Condition? AYes ❑ No Samples on Ice? Yes ❑ No Method of Shipment .Se-6iw 0 Page _ of _ <br />To be completed upon receipt of report: <br />1) Were the analyses requested on the Chain of Custody reported? ❑ Yes ❑ No If no, what analyses are still needed? <br />2) Was the report issued within the requested turnaround time? 0 Yes ❑ No If no, what was the turnaround time? — <br />Approved by: Signature: Company: <br />Date: <br />c <br />m <br />U <br />C <br />a- <br />E <br />!y <br />0 <br />c� <br />0 <br />.0 <br />co <br />Date: s--Ir-S7 <br />Time: /DSD <br />Received <br />Date:- J <br />Time: <br />�O <br />Date:S/ 7 <br />Time: 20 <br />Received BV/ <br />Date: <br />Time: <br />Date: <br />Time: <br />Received By Lab ZL6Z]l <br />1 Date /519 <br />Lime: <br />Were Samples Received in Good Condition? AYes ❑ No Samples on Ice? Yes ❑ No Method of Shipment .Se-6iw 0 Page _ of _ <br />To be completed upon receipt of report: <br />1) Were the analyses requested on the Chain of Custody reported? ❑ Yes ❑ No If no, what analyses are still needed? <br />2) Was the report issued within the requested turnaround time? 0 Yes ❑ No If no, what was the turnaround time? — <br />Approved by: Signature: Company: <br />Date: <br />c <br />m <br />U <br />C <br />a- <br />E <br />!y <br />0 <br />c� <br />0 <br />.0 <br />co <br />