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Histoncal Pipeline Poftfid Analysis Requestl0hain of Custody <br /> Lancaster Laboratodes 2250 For Lancaster <br /> Laboratories use onlyf l <br /> 140mqualityisasc+�r►ce Acct.#: / Group# ' W97 Sample#:Ip 03 7�` <br /> Please print Analyses Requested SCR* <br /> Site/Global ID: Preservation Codes Preservative Codes <br /> H =HCI T=Thiosulfate <br /> Site Address: �_ 3 ` N =HNO3 B=NaOH <br /> 7. <br /> ChevronTexaco PM:c- � Lt.✓a CorZsul t:�C ,Imo!/ y�6O J c \ S=H2SO4 O=Other <br /> cc <br /> G GY U <br /> ConsultanUOfliice:X ❑J value reporting needed <br /> ❑3800 Watt Avenue,Suite 210,Sacrame CA 95821 c <br /> HPP Risk Assessment Detection <br /> 1 i ,�) J o °' Z Limits <br /> Consultant Prj.Mgr.: L 1�✓ '!' / w El ❑ J ` L <br /> o N ❑ El Chromatograms <br /> Consultant Phone#: co o o <br /> o 'r' <br /> Sampler: / 0 <br /> Z m m w o <br /> Field Repeat Top Time New 2 @ w m = _ _ x H <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN O U F.- m a F- <br /> a Corriments,f Remarks <br /> .Wd Alf 7 /ij �c {lam' <br /> 94 -rakao­ <br /> -1 ;7 <br /> 101V > <br /> _ LJ Z <br /> '✓d T <br /> SY 0/ � - <br /> T around Time Requested(TAT)(check box) Reli he Date Time Received b . Date Time <br /> TD.TAT C3 24 hour ❑48 hour7`� 6 <br /> 5 day El '72 hour ❑4 day Reuished by. Date Time Re ived by: Date Time <br /> I <br /> Matrix Values Repeat Values Relinquished by: Date Time Receive by: Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Received by: to Time <br /> W Surface Water or Groundwater T Triplicate Sample ! <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other �� -71- <br /> l <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt �� o us <br /> �C. pH Cust 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.1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should to retained by the client. <br />