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+Uncaster Uombies 0098 ©:F,�/ 1 For Lancaster Laboratories use only <br /> V#f x equftyisasoexe. Acct.#: i� Grow # � ''1 Sam le#: *S O <br /> P P <br /> Please print ..r1. � ,� Analyses Requested SCR#: <br /> Site/Global ID: ac—eloaz—�— —.2 11 Preservation Codes Preservative Codes <br /> Site Address: r7 _57" W [- <br /> " G n RD• OMMO :5 OF � H=HCI T= NaOH lfa#e <br /> N=HNO3 B=NaOH <br /> co <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC S=H2SO4 0=Other <br /> L U <br /> Consultant/Office, ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 c� ❑J value reporting needed <br /> 1800 Watt Avenue,Suite 210,Sacramento,CA 95821 0 ❑ � z ElHPP Risk Assessment Detection <br /> Consultant Prj.Mgr.: Wa1 O�!) ,�-F� A-T� U ❑ > ❑ o 1zLimits <br /> Y] o X N J ooc 0 =1 -6 ❑Chromatograms <br /> Consultant Phone#: �" !�/ Fax#: l�— "7"3 3 /� 0 co � � 0 0 o �, <br /> Sampler: f. SZO+�+I �[, I�W��G. €� U Z �0 El <br /> g cad <br /> p co C4 <br /> N <br /> Q Go <br /> Field Repeat Top Time rlew ca E cc w m "0 co 00Point Name Matrix Sample Depth Year Month Day Collected Field Pt YM U r—° m a a a M <br /> AA <br /> 7r + - .. :p Comments!Remarks <br /> cc <br /> - o TV* Sal C0 Q�7t <br /> ,s-,os- �t� Ct ►1 uP �/G� l <br /> Gni T62 575M PkT <br /> kwo2! T-we <br /> A.e---4,A 19 J. -T t ii <br /> Turnaround Time Requested(TAT)(check box) Reli hed b . DEgeX <br /> ime Re ' ed by: , Date Time <br /> STD.TAT <br /> El hour El 48 hour <br /> '�- <br /> 114 Ira <br /> El 5 day El 72 hour El 4 day fished by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished mercial Carrier: ec ' ed by: 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 <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt ° pH dus4dy Seals lnta Ye No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717}656-2300 4324.01 Rev. 1/14105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />