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For Lancaster Laboratories use only <br /> Sample Lancaster Laboratories 1 MOL <br /> ` �lMxrequalrtyisascience. <br /> Acct #: G '2, LLQ 14 8 SCR* <br /> Analyses Requested <br /> Preservation Codes Preservative Codes <br /> Facility#: — D H= HCI T=Thiosulfate <br /> SiteAddress: w?St a N = HNO3 B= NaOH <br /> Chevron PM: Wb tYajf\ ALead Consultant:_ S=HsSOa O=Other <br /> Consultant/Office: �� a�A�� M 0- 1-t' l C- ' C ❑ ❑J value reporting needed <br /> �;, p ❑Must meet lowest detection limits <br /> Consultant Prj. Mgr.: ;4 0 Y-) /_� ,�l'1� � �/' 1�- r/��5 r t � i� 0 0 `b possible for 8260 compounds <br /> Consultant Phone Llama I—V 1Ay(l Fax kq�bAt0 L-6"I�V a 3N O O 8021 MTBE Confirmation <br /> � 'n [1 Confirm highest hit by 8260• <br /> Sampler: 1 ° E m 0 o = <br /> .o Z ❑ [ICConfirm all hits by 8260 <br /> Service Order#: El Non SAR: a + S 0 ❑Run_oxy's on highest hit <br /> Field Repeat Top Time New U F m m❑ Run_oxy's on all hits <br /> Point Name Matrix m l D t Year Month Collected Field Pt. <br /> C, Comments/Remarks <br /> rmw- <br /> SPI R -D I 15 <br /> Relin ed by: Date Time Received by: Date Time <br /> and Time Requested(TAT)(please circle) I IR p (". <br /> STD.TA 72 hour 48 hour Relin y: Date Time Receive to Time <br /> our 4 day 5 day <br /> Data Package Options(please circle If required) Relinquished by: Date Time Received by: - Date ime <br /> QC Summary Type 1-Full <br /> Relinquished by Commercial Carrier: Fee Date Time <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed <br /> WIP(RWQCB) I UPS Fe x Other 14 <br /> J <br /> Disk Temperature n Receipt Co Custod Seals Inta t? Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster, PA 17605-2425 (717)656-2300 3460 Rev.10/04/01 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />