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Historical Pipeline PonYofid Analysis Requestl0hain of Custody <br /> +L"ast6 <br /> L abO Ql 0 2309 <br /> 3 0 Q t ' /� For Lanca�sterrLLabboratorles use only -7 p <br /> Vv1xy@t�lgkftyisasc�l ma �J Acct.#: I (`'1 ✓ Group#1 r:J ZQ Q7 o Sample#: 6'3D-1136 / C�ci <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: /p"1 '1 O� e'er 41 Preservation Codes Preservative Codes <br /> Site Address: � 1 Or a H=HCI T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> ChevronTexaco PM: tM-8ee-Pot�etiahokr Lead Consultant:SAIC S =1­12SO4 O=Other <br /> U <br /> Consultant/Office: ❑ 2 )O`'0 �'b°'d`'Oi}�S 6 W °' N <br /> 0�1 �t�1��C1• qt/6� 9 p? D ❑J value reporting needed <br /> ❑ ` ((�� a e, 1 0 U) z ;RHPP Risk Assessment Detection <br /> Consultant Pd.Mgr.: ��!�Jl oWr El El ? o G Limits <br /> o �, N El o o - -6 ❑Chromatograms <br /> Consultant Phone#: 38��6 Fax#: d m io o <br /> v <br /> 2 .a N, ❑ F50 0 0 <br /> Sampler: Se Qn Ge �, ; co o a <br /> pa Z ° o � u, W o U <br /> 0 0 <br /> Field Repeat Top TimeNew m o .0� <br /> Point Name Matrix Sample Depth Year Month Day Collected Fiew Pt YIN 0 U m ~ <br /> Y, Comments/Remarks <br /> –5 -- — 2012-01- 2Sr 1145 X -7 ►2,,>!� $�!�ca 9 e <br /> -7 C'CA't,A <br /> �2a d-e�c�trc�S <br /> Tumaround Time Requested(TAT)(check box) Relinquished by: Da` Time Received by: Date Date Time <br /> )rSTD.TAT El 24 hour El 48 hour <br /> ❑ 5 day 1172 hour ❑4 day Relinquished by: Date Time Received Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished b mercial Carrier: R ived by Dat Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS CedV Other 6 (Z Op(f <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt A' - Co pH Custodf Seals Intact? res) No <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 />