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Historical ' / Pofthid Analysis ,'?G%-Iv,%.IestIClitain <br /> A-%,bmaster <br /> .ikOrdt0rie 0322 &f 2y{ For Lan/cyastier�Laboratories use only <br /> ��is a s Acct.M l3 Group# Q -{ Sample M 4 5 a��aa <br /> Please print 5 K fes-1 4 TLA f 71 f G_rA_ t Analyses Requested SCR#: <br /> f Preservation Codes Preservative Codes <br /> Site Address: <br /> �j 500 E�, 4. L�S# Q H =HCI T=Thiosulfate <br /> N =HNO3 B=NaOH <br /> ChevronTexaco PM:M.Soott Mansholt Lead Consultant:SAIC S=H2SO4 O=Other <br /> E U <br /> Consultant/Offioe: El 401 Alberto Way,Suite B,Los Gatos,CA 95032 ❑J value reporting needed <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ �, z ❑HPP Risk Assessment Detection <br /> Consultant Prj.Mgr.: TO D U � v ❑ J o Limits <br /> o 0 0 =) ❑Chromatograms <br /> Consultant Phone#: Fax#: — � ® CD, m o 0 <br /> ��E RC2 ILL L4O 1 t c r E ❑ 0 0 0 0 2 <br /> Sampler: o m o n M M <br /> Zccoo w N 'n %2 �" U <br /> °O o 0 0co <br /> Field Repeat TopOD <br /> Time Naw 0 0 w m = x x = <br /> Point Name Matrix Sample Depth Year Month Day Collected Freta YrN C7 U H m a a IL W <br /> — N 2°1 05-05- 16 tb:24 Y I)C I k X X1 Comments!Remarks <br /> 32 Os-o. -11; 10114s- Ir I X, I IX X wRem <br /> 613a-34 W 3-AL OY-05--1 6 11 145, V X. [0 kv?ww <br /> WlA OLP T1 <br /> fid: <br /> o %Ase. I lac e <br /> IRh —� = 5B -3� ZI on <br /> JeasC <br /> �tAvti $2fo0 OA WARk <br /> SA MPLe5 X021 a�1 Sar <br /> SR <br /> Turnaround Time Requested(TAT)(check box) R nqu by= Date Zime calved by: Date Time <br /> STD.TAT ❑ 24 hour ❑48 hour t <br /> ❑ 5 day ❑ 72 hour ❑ 4 day db = Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: ate Time Received by: Time <br /> S Soil 0 Duplicate sample Relinquished b mmercial Carrier: Received by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt pH Clusdy Seals Inta t. Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev.1114/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />