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! Pipeline ' ! <br /> I Custody <br /> L ` aster Uordb o 0902 t For Lancaster Laboratories use only <br /> 9�yga e Acct.M / Group# / LAD Sample#: <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: UlQ 41? 33 Preservation Codes Preservative Codes <br /> H=HCl T=Thiosulfate <br /> Site Address: :;55Ln UX44 Q(i,'LeYVILi S CA N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC u S= H2SO4 0=Other <br /> L U <br /> Consultant/Office- ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 c <br /> �/ .G 0 ❑J value reporting needed <br /> Id�3800 Watt Avenue,Suite 210,Sacramento,CA 95821 ❑ v, El HPP Risk Assessment Detection <br /> o Limits <br /> Consultant Prj.Mgr.: bA--) bp_nti11S 10 <br /> to S( ©Chromatograms <br /> Consultant Phone#: 61W)G f-Z940 Fax (9qsj35- W m CD o <br /> :? M ❑ rn o 0 <br /> Sampler: E o <br /> aZ mC14u� n <br /> Field Repeat Top Time New m o _ <br /> Point Name Matrix Sample Depth Year Month Da Collected Field Pt YIN v I° m a a <br /> \1 { �{ { Comments!Remarks <br /> ► x ID (fie 5rliccc -/ *VP <br /> mow- N t -1- l53 <br /> v,[-(0 vii! 11 y5 x 1 k x X rjmi aril , <br /> 1 �t to x k x <br /> AAS f MsDcr► a* <br /> Turnaround Time Requested(TAT)(check box) d by: Date Time_j Received b . 1i ate Time <br /> STD.TAT ❑ 24 hour ❑48 hour <br /> El5 day El72 hour El4 day Retinquishe We Time Receiv Date Time <br /> Matrix Values Repeat Values Relinquished by: ate Time Received by: ate Time <br /> S Soil D Duplicate sample Relinquished b Commercial Carrier: <br /> W Surface Water or Groundwater T Triplicate Sample q y ss '{ Received by: Date Time <br /> T Trip Blank-4A Sample N Pre-Purge Sample UPS x Other i4fl �3Y� a <br /> R Rinsate Blank-CA Sample P Post-Purge Sample 7 <br /> M Miscellaneous(e.g.,product sample) TemperatuM<Upon Receip Co pH Custody ea to 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 />