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NEW— <br /> Lyraler I ahra-;*Vw5 <br /> vvr_Mquwgisaxiene" 2213 For Lancaster Laboratories use only <br /> Please print <br /> Acct.#: —f Group# J tl vv 7? le#: t1�f3t7 <br /> _ <br /> Analyses Requested SCR#: <br /> Site/Global ID: U('yZ(����_N ps, (;,��, C; p� a 7-T 9�;3 Preservation Codes <br /> � p0 �,� We "+ Preservative Codes <br /> Site Address: l Rr � `fry <br /> CL <br /> H =HCl T=Thiosulfate <br /> ChevronTexaco PM:M.Scott Mansh !t Lead Co ultant:SAIC '= N=HNO3 B=NaOH <br /> ice: S=HZSO4Consultant/Off1000ro GO=Other59 <br /> ❑3800 Watt Avenue,Suite 210,Sacramento,CA 95821 2 ❑J value reporting needed <br /> U a- <br /> Consultant Pd.Mgr.:_C n F�., �� 2 0 ❑ z ❑HPP Risk Assessment Detection <br /> �7 'f <br /> a4 _Z c�►1 l! _V ❑ ❑ �` w Limits <br /> Consultant Phone#: Jt��7ti7(p 7 27 Fax#: 9 rljv' 779-3735- o �" N ❑ 0 ❑Chromatograms <br /> cc � <br /> Sampler: A. tr Y 1l S'�3 L t-0 m -0 ❑ ❑ � 0 0 0 <br /> r � _. <br /> rn ccoo m o M <br /> Field ° Z o N � U') <br /> ' �' <br /> Repeat Top Time New (a E m x w $ C—:) <br /> a <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt Y/N 5 U I° m a F w <br /> U8' 07 1,�5" <br /> MW-7 \A/ — (250 1 q y �- Comments!Remarks <br /> M - tC21 I <br /> N 2 �C It <br /> M - \d — o u cl ear.►-r � � TP;+� <br /> Turnaround Time Requested(TAT)(check box) Relinquis y: <br /> ate Time Rec ' by: <br /> ❑ STD.TAT ❑ 24 hour ❑48 hour ! Time <br /> X5 day ❑ 72 hour ❑4 day Relinquished b Date a Received by:� <br /> Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: <br /> Date Time <br /> S Soil D Duplicate sample <br /> W Surface Water or Groundwater T Triplicate Sample Relinquished b Commercial Carder: a Ived by: <br /> T Trip Blank-GA Sample N Pre-Purge Sample <br /> UPS <br /> FedEx Date. Time <br /> R Rinsate Blank-QA Sample P Post-Purge Sample Other w� �o <br /> M Miscellaneous(e.g.,product sample) p <br /> Temperature/pH Upon Receipt —C. H <br /> p Cu t dy als 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 />