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Historical Pofflbfid Analysis RequestlChain 1 Custody <br /> Laxastle Uoratores 0974 For Lancaster Laboratories use only <br /> IM qualtya � .ascierAcct.#: Group# 10 f 2.$(-a sample#: 5Z99 733 —?C/o <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal ID: a m" 5 04s:}-e_ Preservation Codes Preservative Codes <br /> C+ H=HCI T=Thiosulfate <br /> Site Address: `r 33 We-ti „ I VefM.1"54 tom- N=HNO3 $=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC a S=H2SO4 O=Other <br /> i U <br /> Consultant/O#fice: El 401 Alberto Way,Suite B,Los Gatos,CA 95032 0 ^' ❑J value reporting needed <br /> 3800 Watt Avenii `` <br /> u'e,Suite 210,Sacramento CA 95821 0 © V, z E]HPP Risk Assessment Detection <br /> Consultant Pry.Mgr.: JtO �.l 'j' U El El > w Limits <br /> ❑ p U <br /> o N N o o ❑Chromatograms <br /> Consultant Phone#:So–Y44 --717 S Fax#: 5!0-t1i16'?91°I 4> � C) � = o n C)IQ.� �h m ❑ 0 a o 0 <br /> Sampler: �p,Y+ S^'1+ CD o 2 2 a <br /> 0 Z co N u7 sn U <br /> Field Repeat Top Time New (a o 3 w m = _ _ _ <br /> Point Name Matrix Sample Depth Year Month Day Collected FieldRY1N (D U m M a F F-- 2 <br /> '2N s S' OS-,o2- vo I!39 Y X Comments 1 Remarks <br /> Si3-21� — 36. 01~07--2-ti 13t0 y <br /> $ -29' 5 oi- O2 -24 f153 t <br /> !S%- Zg — 3B' a8' oz -ZL )45o x 1 <br /> -2 - S ' as - 0i-2''] OB os <br /> 3 -ZrZ —_ 33, 0%-0-Z -a'7 09so `( X 1 <br /> CA.SO <br /> - <br /> Sb - 2 So S 1� 0%-02-211045 t <br /> Turnaround Time Requested(TAT)(check box) Relinquished by: DateC Time Received by: Date Time <br /> STD.TAT 1124 hour El 48 hour ?W+s 1700 <br /> LJ 5 day El 72 hour El 4 day Relinquished by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished b Date Time Received Date Time <br /> S Sal D Duplicate sample Relinquished by C mercial Carrier. Rec a by: ate Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pr(--Purge Sample UPS ed Ex Other Z)g- . <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receiptd c� C° pH Custody Seals Intact? a 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 /> I <br />