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Lancaster Laboia WRS 1889 <br /> r For Lancaster Laboratories use only T -t <br /> Wfteregll�aftyisasrJerm Acct a� 1 Group# aQcl97q Sample#: (OV3 !oma 3 S <br /> Please print n/ Analyses Requested SCR#: <br /> Site/Global ID: y� ✓YPi Preservation Codes Preservative Codes <br /> Site Address: CL <br /> N=HNO3 B=NaIOH Ifate <br /> ChevronTexaco PM: 1 noll Leadsuftant:SAIC yd S=1-12SO4 O=Outer <br /> ConsultanUOffice:�484-illbert rt7es+.a{�D3c� c_ []J value reporting needed <br /> aHPP Risk Assessment Detection <br /> —_ ❑3b�Cn0�Watt/1tra=u�,R„ita gin Sanmrnardn Cn a5R21 in z. thefts <br /> Consultant Pry'.Mgr.: yy r-JZ :�2457, OC� U ❑ ❑ El � � <br /> o 0 0 ❑Chromatograms <br /> W or <br /> Consultant Phone#: - 3 -7 Fax <br /> E ❑ "' 0 0 0 <br /> L <br /> Sampler: cm Ln � ,L <br /> Z m $ rn <br /> Field Repeat Top Time v o a uj <br /> Point Name Matrix Sample Depth Year Month Day Collected Ft�w" YM ~ <br /> '> 1 a Comments!Remarks <br /> — 157 <br /> 07-1 <br /> Turnaround Time Requested(TAT)(check box) Relin Date Time Received by. Date Time <br /> TD.TAT ❑ 24 hour 1148 hour <br /> ❑ 5 day EJ 72 hour El 4 day Relinquished by: to Time Receive by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received b Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier. Received b ate QTime <br /> 1Z <br /> W Surface Water or Groundwater T Triplicate Sample ��- <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> R 14insate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g..product sample) Temperature/pH Upon Receipt 7-, V-C° pH y Seals Intact? es o <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 />