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lows! I <br /> Lancaster Laboratories 't For Lancaster Laboratories use only <br /> 2212 <br /> 'WMXr'e ISaSClenCL' Acct.#: Grou Sample#: <br /> `.�� SCR* <br /> print <:.. : . i.' " <br /> Analyses Requested <br /> s y q <br /> Preservation Codes Preservative Codes <br /> Site/Global ID: i :• HCI <br /> - <br /> _. .� :r a N =HNO B=NaOH lfate <br /> Site Address: v <br /> ChevronTexaco PM:M.Scott Mgnshblf;;Lead Coritt0ant,SAIL, Kr' S H2SO4O=Other <br /> = <br /> . Consultant/Office: *01:) is Vyay, t7Re B,Los,G 9 "aa ;``'=y?' c 0 A ❑J value reporting needed <br /> 4"z�": co <br /> ❑3800 Oi�a'fi'7�v ridi Str7te 2tf? , 821 0 ❑ ❑Limits <br /> Risk Assessment Detection <br /> y� { w <br /> Consuftei3tPrjfirlgr..:. '°y:.'� .i,, :r. .. `f v<-�. to ❑ d o o foo- ❑ 9 <br /> `� : ., ❑ � o o v <br /> Chromato rams <br /> ConsultantaP one#: Fax#: w °° 65 0 0 010 <br /> Sampl t "�n CN N u, v <br /> N 0 Z ap OD N <br /> T a m O O � J <br /> Field Repeat Top Time New .;o o w m 's = = a w <br /> Poi0t NaAie Matrix Sample Depth.Year Month Day Collected Field Pt YIN c7 U F- m � a � � ~ g <br /> — s.., I f 573 Comments/Remarks <br /> _ 1 w 'vti p, .. ..' <br /> I I <br /> �._ <br /> cot- ;_/t v_-1. <br /> Relin wished b +' / at Time Received by;.. Pate Time <br /> Turnaround Time Requested(TAT)(check box) q y, j 7 <br /> ��STD.TAT El24 hour El48 hour <br /> 5 day El 72 hour El 4 day Relinquished by: Date Time Received by: Date Time <br /> Relinquished by: Date Time Received by: Date Time <br /> Matrix Values (Repeat Values <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Received by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g product sample) Temperature/pH Upon Receipt C° pH Custody Seals Intact? Yes No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev.1/14/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client, <br />