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Lancaster LaboraLo(les 0941 .f For Lancaster Laboratories use only `J AJC n <br /> i/Vherec�k3� isasciefxe. Acct.#: f/ I 3 Group# /V 3L,Y Yom] Sample#: S c3 i {`7 &r'— ?n <br /> Please print tAnalyses Requested SCR#: <br /> �� n <br /> Site/Global ID: ye+-'Io S �u��+P 5 s��54 Preservation Codes Preservative Codes <br /> Site Address: S 0 D JO['i4-In Rocj , Ver rW_ 5 Cq H =HCl T=Thiosulfate <br /> J N =HNO3 B= NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC S=H2SO4 O=Other <br /> Vl U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 ❑J value reporting needed <br /> {y SS U <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 958210 ❑ U, ElHPP Risk Assessment Detection <br /> Limits <br /> Consultant Prj.Mgr.: 01ki-i s l� In iS U J <br /> 0 orr ❑Chromatograms <br /> Consultant Phone#: I 4 7 �3�o Fax#: t�C ' of 7 - 37 3S a) o <br /> SamSampler: � m C <br /> p /C.r� �� 'r�Ce2 Z N <br /> Q m o <br /> Field Repeat Top Time New oit � I I I I <br /> Point Name Matrix Sample Depth Year Month Day Collected FieldPtllN c7 U a <br /> Ar Nit 0 O's ot 1C) S X X.I Comments 1 Remarks <br /> M N- N h O} 0 d 1 ! 1 p X a X S+1►cc� <br /> A- <br /> VAW <br /> NA ccs Jim its. <br /> �s iv1s� -tom&O u� <br /> NMVQ (0 <br /> / <br /> Turnaround Time Requested(TAT)(check box) Ren uis b a Time eceived b : Date Time f y 51 a7 0730 y <br /> OSTD.TAT ❑ 24 hour ❑ 48 hour <br /> El 5 day El 72 hour El 4 day Relinquished by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Date Time <br /> 5 Soil D Duplicate sample Relinquished by Commercial Carrier: Reflived by: Date —Titne <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other 5! <br /> R Rinsate Blank-QA Sample P Post-Purge Sample 67 <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt a pH Custody Sea In act? Yes <br /> IfQ r 4324.01 Rev. 1134105 <br /> 3 O d Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />