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I . I <br /> 40Wxye qu ster Laboratories Acct # �,p SamA e#' g ° as 2 4 0 5 4 <br /> u�c)i�rtyisa soen�ee <br /> I"rr f- cl f_ Analyses Requested C--,IfDT 75 9 <br /> Facility# - ! N Preservation Codes Preservative Codes <br /> Site Address --j YQSOrale , ' , II i4 H=HCI T=Thmsulfate <br /> -�---- tD N=HNO3 E3=NaOH <br /> Chevron PM D_T k�t�li IA4/ Lead Consuttant tD S=H2SO4 0=Other <br /> U <br /> Consultantl0ffice ❑ ¢ ©J value reporting needed <br /> ElMust meet lowest detection limits <br /> Consultant Pq Mgr <br /> possible for 8260 compounds <br /> o ❑ <br /> U <br /> Consuftant Phone# 9l6 }-3z/o-+ Fax# film oil-2 J� a � � a � � 8021 MTBE Confirmation <br /> Sampler 4 mj 2 a a ❑Confam highest hit by 8260 <br /> Service order# ❑Non SAR IN <br /> _ []Confirm all hits by 8260 <br /> CL <br /> F1eldRepeat Top Time New Q E m ac a p Run_oxy s on highest hit <br /> Point Name Matrix Sample 2ML Year Month vI p Run oxy's on all hitsiet <br /> rs ,V d, Z6, 096-0 t` Comments!Remarks <br /> �� rt ©90 I 7C K K <br /> 93 6 16e x , 15- <br /> la-s�?r rq <br /> g "(071 x "VIME, DIP, <br /> X Xas 1 XL -bX k X <br /> �S x <br /> x x <br /> T round Time Requested A u Dat Time rued by Date Time <br /> eq (TAT)(please Grcle) l0 <br /> D TAT 72 hour 48 hour R hn is ase T e Received by Date Time <br /> 4 day 5 day <br /> Package Options(please circle if required) <br /> Relinquished by- <br /> Data Dale Time Received by a Time <br /> QC Summary Type t--Fuft <br /> Type VI(Raw Data) ❑Coelt Delrverable not needed Relinquished encial Carrier Rec d by Date Time <br /> WIP(RWQCB) UPS FedEx 2 Other t <br /> O <br /> Disk Temperature Upon Receipt C. Custody Seals I Yes <br /> Lancaster Laboratories Inc. 2425 New Holland Price,PO!lox 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 /> I <br />