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Historicol Pipeline Poiffolto Anolysis RequestlChoin of Custody <br /> +LaKaSW UWWRS 0 8 0 8For Lancaster Laboratories use only <br /> l A&equa isasckme Acct.#: �� Group#/C67044_1 Sample#:5+ 1 930'3_7_L4Q J <br /> Please print ] Analyses Requested SCR#: <br /> T <br /> Site/Global ID: t m&(t5 Tump 'S�t.*'orl /S L o te6,IT456 3-3Preservation Codes Preservative Codes <br /> Site Address: SJUD �rf-h WP_IfV '�� 'AR W(gt r k H=HCI T=Thiosulfate <br /> ?+ R N =HNO3 B= NaOH <br /> ChevronTexaoo PM:M.Scott Mansholt Lead Consultant:SAIC m S=H2SO4 O=Other <br /> y U <br /> L <br /> ConsultantlOffice: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 c 0 ❑J value reporting needed <br /> F <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ ElHPP Risk Assessment Detection <br /> Tom <br /> ,�w(05 o Limits <br /> Consultant Prj.Mgr.: w J - <br /> } 3 o ❑Chromatograms <br /> Consultant Phone#: Fax#: ��/ 0 o <br /> rn o <br /> Sampler: 44ickc-& y-Ka1& o D <br /> CL z co <br /> Field Repeat Top Time New o o Q <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN C7 U 1-- a <br /> NA <br /> ® Comments I Remarks <br /> W— Co la-21) Al 1 I s`CCfi i <br /> TXA <br /> aA- tit IN_(P. <br /> Turnaround Time Requested(TAT)(check box) \ Relinq sh d Date Timee b Time <br /> XSTD.TAT ❑ 24 hour ❑ 48 hour <br /> ❑ 5 day ❑ 72 hour ❑ 4 day is d D to Time R ceived by: D to Time <br /> a� <br /> Matrix Values Repeat Values Slinquished by: ate Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished b ercial Cagier: Re b a Time <br /> W Surface Water or Groundwater T Triplicate Sample - . <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx other 19 <br /> R Rinsate Blank-QA Sample P Post-Purge Sample ij <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Reoeipt I: pH Custody Seals Intact. Yes No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 25, a' er,PA 17605-2425 (717)656-2300 4324.01 Rev. 1/14/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />