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+bm-Ker Laboratories 0723 ) For Lancaster�jb(�raattosles use only � i , �n �'} <br /> VW)erec_afitycsasc Acct.#: r Group# IOV�` 4a Sample#. `3 �'�! c7'7 7 Or—� <br /> Please print Analyses Requested <br /> SCR#: 5 7 <br /> SitelGlobal ID: U Preservation Codes Preservative Codes <br /> Site Address: <br /> -Sr � �� + r'� 1 t C74 H= HCl T=Thiosulfate <br /> N , ,� N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIL m S=H2SO4 O=Other <br /> U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 DN <br /> 0 ❑3 value reporting needed <br /> to a- <br /> ,*800 Watt Avenue,Suite 210,Sacramento,CA 95821 0 ❑ co z Euj l Risk Assessment Detection <br /> its <br /> Consultant P6.Mgr.: c5Deonis o N n El 19 0 0 <br /> ❑Chromatograms <br /> Consultant Phone#:�lC 1 ! 31@47G Fax#: �(pl�t — 0 CO CO 2 <br /> Sampler EJCr y Z © © N 2 LO U <br /> 2 < <br /> 0co co <br /> 4 co00 <br /> uj co Go <br /> o o <br /> Field Repeat Top Time New Z o o W m _ z z w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field R Yna 0 U Co a W <br /> OA WA Ax' Comments!Remarks <br /> 04 jL: NA_ A6P o C S'1 s'crxq�I <br /> 1AES M VY-I WA <br /> N O �w? att'lPl <br /> D <br /> WFS MW-�. <br /> Turnaround Time Requested[TAT](check box) Rel' qui ed y: Date Time Received by/ a ITimeVSTD.TAT ❑24 hour ❑48 hour❑ 5 day ❑ 72 hour ❑4 day Relinquts y: e e b ate Matrix Values Repeat Values Relinquishe by: Date Time Received by: Date <br /> S Soil D Duplicate sample Relinquished ercial Carrier. Cao R ei ed by: D to Time <br /> W Surface Water or Groundwater T Triplicate Sample CZM <br /> T TripBlank-QASample N Pre-Purge Sample UPS FedEx Other A40— <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> mD <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt CO pH C. stody Sea tact? Yes Na <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 />