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Historical Pipeline Porfiblid AnalysisRequestlChain 1 Custody <br /> lancer Lkoratories 2605 For Lan r Laboratories use only g <br /> VAffequaFitysascer" Acct.#: Group# 1 �,b Sample#: 1 ■ <br /> w 3 <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: C Aclfv A D SLaC01.7-Y6`f 7o Preservation Codes Preservative Codes <br /> &-t, ice H=HCl T=Thiosulfate <br /> Site Address: '� TT 3 N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC d S=H2SO4 O=Other <br /> i U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 ❑J value reporting needed <br /> a <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 o m z <br /> HPP Risk Assessment Detection <br /> Limits <br /> Consultant Pd.Mgr.: [�r f d w ❑ ❑ o <br /> _ O N N ❑ c2 O0f =W -06 ❑Chromatograms <br /> CD <br /> Consultant Phone#: at �„ <br /> 0 <br /> Sampler: . S/�•� �- CP a N E 0 0 c M 2 M i <br /> p Z CN ,nLu <br /> ,n in U <br /> co ZD_ <br /> Field Repeat Top Time New o o .3m = _ _ <br /> C. <br /> Point Name Matrix Sample Depth Year Month Day Collected Fled Pt YIN C7 U H m g a <br /> OZ Comments!Remarks <br /> w -3 w T _ 09 0z 11 Z66 1 ;� � t. v <br /> w- <br /> �� ►mss J.�sa <br /> CG I lac fc.� �ar <br /> .mow-3 <br /> 2 <br /> vS s•I�cam► t <br /> f <br /> C�c��c�io+� U,rrr�S <br /> Turnaround Time Requested(TAT)(check box) Relinquis Y. Time Received b Date Time <br /> STD.TAT El24 hour El48 hour <br /> ❑ 5 day ❑ 72 hour ❑4 day Pate Time Receyed bye Date Time <br /> P <br /> Matrix Values Repeat Values Relinqu ed by: Date Time Rec by': Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: eceiv by- Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS d x Other ' � t I rj <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt t-Lt- �C° pH Cus y Seals Int t? &s 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 />