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— wit i W1 Custody <br /> Lancaster Laboratories O O 5 4>�q e?— X AcFor Lancaster Laboratories use only <br /> z#tycsascie ct.#: � ��� Group# q�[` ' <br /> L{0 q-7) Sample#: L4 S_�74 �a —33 <br /> Please print ! �ERA <br /> t ,tf. Lfi� P �p N Analyses Requested SCR#: <br /> Site/Global ID: L7 is- V Q — oz— j — Preservation Codes Preservative Codes <br /> T S H= HCI T=Thiosulfate <br /> Site Address: a N= HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC m S=H2SO4 O=Other <br /> L U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 r5 <br /> � a ❑J value reporting needed <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 N z PP Risk Assessment Detection <br /> Consultant Prj.Mgr.: Db Da U ❑ > ❑ Lou 0 Limits <br /> Consultant Phone#: 0 f -• _ 7 0 0 0 El Chromatograms. <br /> Fax#: / a� ao � co v <br /> p L cj� e2 f� SCDC,( �� -0 El 0 o o 0 Q <br /> Sampler: � CO o M <br /> O Z ro � N LO in L U <br /> Field <br /> a co <br /> " 0 0 0 <br /> co <br /> Repeat Top Time New t�La o (a w m = _ <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN 0 U m a a- <br /> N It ur X I Comments 1 Remarks <br /> s �S <br /> f- 1 <br /> 14:0 <br /> turnaround Time Requested(TAT)(check box) R quish by: I Date 'me ed by: Date Time <br /> ,CSTD.TAT ❑ 24 hour ❑48 hour <br /> ❑ 5 day ❑ 72 hour ❑ 4 days by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Time <br /> S Soil D Duplicate sample Relinquishe rcial Carrier: Received by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-GA Sample N Pre-Purge Sample UPS FedEx Other � <br /> R RinsateBlank-4A Sample P Post-Purge Sample469�f_W <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt �C° pH Custody Seals Intact? Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 92425,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 />