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Hisforical PipeAne + 1 1 Anatysis RequestlChohn of Custody <br /> Lwcaster 0057 For Lancaster Laboratories use only f � ^ <br /> Vt9 qu ylsasci Acct.#: 3 Group# S f�. Sample#: ' lS�oZ®CLOQ-- <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal ID: MALAl r104H 504-rIbli Preservation Codes Preservative Codes <br /> liilE4,Ta go AD AO' AA H=HCI T=Thiosulfate <br /> Site Address: CL <br /> N=HNO3 B=NaOH <br /> co <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC _co S=H2SO4 O=Other <br /> i U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 I a- <br /> c -a ❑3 value reporting needed <br /> 800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ `r' z <br /> El HPP Risk Assessment Detection <br /> o <br /> Consultant Prj.Mgr.: '©D 1 C IZA U El _>j El o Limits <br /> ❑Chromato rams <br /> / O N w ❑ a a' U U g <br /> Consultant Phone#: — Fax#: 6 0) . co <br /> r,1 !I � ° o 0 0 dPh��PDSA <br /> Sampler: W iJM 76o/�j I k Q Z cc � 2 2 o 0 <br /> co co <br /> Field Repeat Top Time New cc co <br /> o `:° m = _ _ _ <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN (7 U Co a- P P <br /> ,S6-2-9 N 20 .2 Comments 1 Remarks <br /> —2-q N 71 nq o5 zo {oLD SQ Zy--71 <br /> LPL 014 )IJ - 05 05 2- ! K, X XiX AND OA <br /> Ru►l7 Cho l`f o/i <br /> 72- HQ rA7- <br /> CWLY <br /> S SE &dW-c 1 <br /> 2�o I 'Ile <br /> Turnaround Time Requested(TAT)(check box) Re bey: at Time ceived by: Date Time <br /> 1<STD.TATq 24 hour El48 hour <br /> El5 day 72 hour El4 day lingcns Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Time Received by: Da Time <br /> S Soil D Duplicate sample Relinquishe o ercial Carrier: Re i ed by: Date Time <br /> W Surface Water c Groundwater T Triplicate Sample �.� <br /> T Trip Blank-OA 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 pon Receipt �C° pH Custody Seals t ? Yes 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 />