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r <br /> Histoficai Pipeline Poftfio Analysis RequestlChain of Custody <br /> Lancaster L.aboraWes All-886 j For Lancaster Laboratories use only }� 2 <br /> V herpgt�alGtyisasckme. Acct.#: + Group#I of✓��2� / Sample M(0 U J 9960 --S <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: LPreservation Codes Preservative Codes <br /> Site Address: LV V�fj;�• 7 o H=HCl T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> ChevronTexaco PM: r ead Consultant:SAIC d S=H2SO4 O=Other <br /> ConsultantlOffic i ils 0 ^� Cval a reporting needed <br /> a Risk Assessment Detection <br /> 3800,W.attt Avenue,Suite 210,Sacrammento,CA 95821 0 ? <br /> Consultant Prj.Mgr.: Vl/ , X w ❑ ❑ <br /> !� p N N Or 0 ¢ ❑Chromatograms <br /> Consultant Phone#: C — Fax M 5 fe"Iw , m C ° n <br /> s� ❑ o o 0o <br /> o o <br /> Sampler rn o � o <br /> O Z m N u� U <br /> CL oo O O J <br /> co co <br /> Field Repeat Top Time New m e o w m = _ _ w <br /> Point Name Matrix Sample Depth Year Month Da Collected Field Pt YIN 0 U H m � a � � <br /> � } Commen !Remar s <br /> x i'e' <br /> Turnaround Time Requested(TAT)(check box) Relinquished Date Time Rec ' by: Date Time <br /> TD.TAT 1:124 hour ❑48 hour <br /> ❑ 5 day ❑72 hour 114 day Relinquished by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values <br /> Relinquished by: _ Date Time Received by: Date Time <br /> --•-.� <br /> S I Soil D Duplicate sample Relinquished redF <br /> merciat Carrier: Rec ived by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample + r' <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS x Other a)v <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt pH C° pH Custody teats Intact? Q-0 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 />