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Historical ' • ' PortfolioAnalysisRequestl0hain / Custody <br /> +L"2sterL&=Wies 2252 For Lancastg Lab-oratorios use only ��,�} _ (] <br /> WhelegtJd16fy6asc+elKe. Acct.#: ! Group# t a'7 `o'57 I Sample#: C0!5 h l� <br /> Please print r rJ CJ Analyses Requested SCR#: <br /> Sde/Global ID: he% 477r Preservation Codes Preservative Codes <br /> Site Address: Vern")t 15 4 CA- H= HCI T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> S=H2SO4 O=Other <br /> ChevronTexaco PM: Lead Consultant:SAIC <br /> Consultant/Offioe: ❑ '7 c�. <br /> ' oaldt,,ot $U 6`7S/ CR 0)��/ ri ❑J value reporting needed <br /> ❑3800 Waft Avenue,Suite 210,Sacramento,CA 95821 c a <br /> ❑ � z HPP Risk Assessment Detection <br /> p(,/J o ❑ o 6 Limits <br /> Consultant Pry'.Mgr.: w ❑_ ❑ J w <br /> _ r M ❑Chromatograms <br /> Consultant Phone#: _ S� " b3$-7655 C�"'�' @ S°r•c.0 o N o 2 (5 0 <br /> Fax S�✓� W m M o <br /> rn -QISl ❑ "' $ $ o <br /> Sampler: Scan Ge� 14 'rn E � o � � � 0 $a <br /> 0. Z co co00�' o <br /> m 0 <br /> Field Repeat Top Time N.K o o 0 _ _ a W <br /> Point Name Matrix Sample Depth Year Month Day Collected Fleld Pt YM O U m M a '- M <br /> 2012 02 21K 1030 �-1 iY, 1XI X I Comments/Remarks <br /> 201.2 02 2Y 1056 ! X K 1XI <br /> 3� -2012 02 25i I IL41 <br /> O 12y� ► H011 Sri-I <br /> S - 3 ` 201Z oz 2 135 X AX E�. 5 ' ,oimdt <br /> nal Arta]-lit <br /> IS <br /> Tumaround Time Requested(TAT)(check box) Relinquished by: Date Time Rec ive by: L Dat Time <br /> X STD.TAT ❑24 hour ❑48 hour 9 7 ls/D <br /> El 5 day El 72 hour 114 day (Relinquished y: Date Time Re lved by: Date Time <br /> C.ti <br /> Matrix Values Repeat Values Relinquished by: Date Tim Receive y: Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Received y: Date Time <br /> Surface Water or Groundwater <br /> W SurT Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other i <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt Bt ^CO pHCust Seals In ct? 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 dient. <br />