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Historical ' • 1. 1 1AnalysisRequestlChainofCustody <br /> +Lancastier Labordtofllnt� For Lancaster Laboratories use only Q y } <br /> Where #afltyisascrerr 221. t- Acct.#: •� Group#� 1� �;t 3 1 Sample#: 514 18 1 L4-7" 5 ! <br /> Please print 5 LO 6 C 774f9 S 3 Analyses Requested SCR#: <br /> Site/Global ID: V e_ n"` t `7 "'"P Preservation Codes Preservative Codes <br /> t H=HCI T=Thiosulfate <br /> Site Address: 3 ,�EO CJ 5c-, w 1- t+Y R N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIL S=H2SO4 O=Other <br /> N U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 's ! 0 ^' ❑J value reporting needed <br /> �:,G6 IZjr•��t� Svt 1 CSh ��Ctnc* t6 a <br /> ❑^^^^ ro Gln c _o____ra CA.96821 0 ❑ co z ❑HPP Risk Assessment Detection <br /> El <br /> �' Limits <br /> Consultant P Mgr.: y1 CC�^�'t , L►�VC, �, r]� El El <br /> W U <br /> 0 9 �'�Y Y o 0 0 0 U ❑Chromatograms <br /> Consultant Phone#: �[CJ }'�b 6-���7 Fax#: G -Ff�(3 }�f Cj © ° a o o <br /> Sampler: _ iy1 r �+ ��S 0 0 0 <br /> O Z co co N UD `n o, <br /> a co o a co <br /> Field Repeat Top Time New o o � m = = = a w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN o a a <br /> VV Ib U } U N n Comments 1 Remarks <br /> OV�� Silo ems. c3 <br /> c)g- 2� <br /> — X tt� Ch <br /> M 5��T7 �` <br /> Turnaround Time Requested(TAT)(check box) Relinquished by: Date• Time Received by: Date Time <br /> 717t LaG� �� ZZ(7 <br /> ❑rSTD.TAT El 24 hour El 48 hour <br /> 5 day El 72 hour El 4 day fbM <br /> Relinquished by: Date Tim Received by: Date Time <br /> Matrix Values Repeat Values Relinquished b Date Time Received by: Date Time <br /> S Soil D Duplicate sample Date Time <br /> Relinquished bercial Carrier: eceived by: <br /> :*"— <br /> W Surface Water or Groundwater T Triplicate Sample z <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other ' (}E� 10 <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt [`2, C° pH Cust dy Se#Intact? es No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike, PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. Ill 4105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />