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U 680 Chesapeake Drive • flodwood City, CA 94063 • (415) 364-9600 U 18939 120111 Ave., N. E., Suite 101 • Bothell, WA 98011 • (206) 481-9200 <br />UNOCALU 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 IJ East 11115 Montgomery, Suite B • Spokane, WA 99206 • (509) 924-9200 <br />• <br />X404 N. Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9601) U 15055 S.W. Sequoia F'kwy, Suite 110 • Portland, OR 97222 • (503) 624-9800 <br />Consultant Company: <br />��`(''('L �R _.. �� Ne � <br />Project Name:"( -®S Co <br />TRftC, <br />Address: 6 <br />C <br />u `�{-� �! <br />UNOCAL Project Manager: <br />V CWLLE: <br />I <br />City: Q 13' L_State: CPA <br />Telephone: �. tJ J �-- �J `u Jr- <br />Zip Code. y-156 X <br />FAX #; 5 S7' <br />AFE #: t ; �, ", r e P <br />" <br />Site #, City, State: 9'3"q 5 1 t el C V LV <br />Report To: ISameler: QC Data: Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br />Turnaround ❑ 10 Work Days ❑ 5 Work Days ❑ 3 Work Days F_j Drinking Water lAnalyses Requested <br />Time: ❑ 2 Work Das Al Work Day ❑ 2-8 Hours ❑ Waste Water <br />P <br />CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. U Demol. ❑ Closure Other <br />Client Date/Time Matrix # of, Cont. Laboratory ® .!` <br />Sample I.D. Sampled Desc. Cont. Type Sample # Comments <br />,.- 3 <br />8 <br />5 olL <br />os1� tom' <br />v <br />v <br />L.,- <br />L.,-- <br />v <br />R�S�Lr <br />2. <br />�°d .05 <br />3. <br />GY 9'100 RM <br />4. <br />1 6 LIM <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />Relinq ' hed By: NUWW <br />Relinquished By: <br />uished B <br />P <br />Date: <br />Date: <br />Date: <br />Time: tReceivedB : <br />Time: B : <br />Date: Time: <br />Date: Time: �Relin <br />tA�`" u�'���- <br />Date Time: <br />Were Samples Received in Good Condition? Yes ❑ No Samples on Ice? Yes U No Method of Shipment_- Page _ of _ <br />o be completed upon receipt of report: , <br />1) Were the analyses requested on the Chain of Custody reported? Q Yes ❑ No If no, what analyses are still needed? <br />2) Was the report issued within the requested turnaround time? ❑ Yes U No If no, what was the turnaround time? . <br />Approved by: <br />Signature: _------._ __--Company. <br />Date: <br />