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Ir Of jp <br /> Lwxa4er L.korlores 0767 j I For Lancaster Laboratories use only <br /> WvregAAyisaSCler' . 1 <br /> 1 t� Acct.#: 1 ! Group# lh3 53 Sample#: <br /> Please print '9 r t Analyses Requested SCR#: /�3 <br /> Site/Global ID: Ds ra m-wei L''�[ $L f&oT � 7� 7d Preservation Codes Preservative Codes <br /> Site Address: ?l5 of 5 LI/114 R ✓ei'IIS C4 H=HCI T=Thiosulfate <br /> g IN=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC d S=H2SO4 O=Other <br /> U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 c ❑J value reporting needed <br /> ca <br /> ;<3800 Watt Avenyu�e,,Suite 210,Sacramento,CA 95821 � ❑ v, ❑HPP Risk Assessment Detection <br /> Consultant Prj.Mgr.: eA)7s IXN� U > Limits <br /> " 1 0 Doc ❑Chromatograms <br /> Consultant Phone#: l7�(/J Q -�cp+r0 Fax#: lrP 1 y -3�.3� m <br /> Tr. 6*� m <br /> Sampler: L, C iM [� � � � 2 <br /> 0.E z co <br /> o <br /> 0 co <br /> Field Repeat Top Time @ o o X: <br /> EL <br /> Point Name Matrix Sample Depth Year Month Day Collected Fleld Puna C? 0 I- <br /> �� �g N Comments!Remarks <br /> W Oq 90i 33 O Al U�p 'T Tf fi�ai <br /> Turnaround Time Requested(TAT){check box} Relinquish y: Date T' e I ed by: �D e <br /> YSTD.TAT ❑24 hour ❑48 hour <br /> ❑ 5 day ❑ 72 hour ❑4 day R ed by: Date Time Received by: 1D a Time. <br /> OWE, 7 Av <br /> Matrix Values Repeat Values elin 'sh b . It Time a ive y: Date Time <br /> /61S 6 <br /> S Soil 6 Duplicate sample Reli qu ed b m r Carrie: s'Id Received by: ime <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample x er <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Reoeip � C° plyceoL '4"� ustody S s intact? Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 {717}656-2300 4324.01 Rev.1114105 <br /> Cop les:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />