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L-aw2ste` LabOrlo6es 2 2 5 0For Lancaster Laboratories use only <br /> mere gAtyis a Scierm Acct.#: 7 J3 Group# I 1 OAA 7zi Sample* L-63-7,30,Z <br /> Please print Analyses Requested SCR#: <br /> Sit0lGloballD: We <br /> Preservation Codes Preservative Codes <br /> Site Address: <br /> yl/� H=HCI T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> ChevronTexaco PM: c S Lead Co sultant:S C m S=H2SO4 O=Other <br /> i /�rXol,✓a ,IGwal ecff6Q�' <br /> ConsultantlOffice: L s a) <br /> X i ❑J value reporting needed <br /> ❑3800 Watt Avenue,Suite 210,Sa cra mer1le CA 95821 c N z HPP Risk Assessment Detection <br /> o <br /> Consultant Prj.Mgr.: \ L� U ❑ ❑ j o Limits <br /> o N �, 0 <br /> 0 0 - []Chromatograms <br /> 76 <br /> Consultant Phone M � Fax#: _� as o CC- 0 oU <br /> n E] m a o o LD <br /> Sampler: o � . o o 2 M 0M e-h 12 <br /> Field Repeat Top Time New m E :° '< m co °° i <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN C7 U F"- m <br /> Co ents!Remarks <br /> _- 7 � NL <br /> f <br /> sem_ ' <br /> Tu around Time Requested(TAT)(check box) Reli 'she �' Date Time Received b _ Date Time <br /> 11 <br /> TD.TAT ©24 hour El 48 hour T� 6 <br /> 15 day El 72 hour ❑ 4 day Re" quished by. Date Time Re ived by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Receive by: Date Time <br /> S Soil iJ Duplicate sample Relinquished by Commercial Carrier: Received b to Time <br /> W Surface Water or Groundwater T Triplicate Sample Y� <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other 7 J f <br /> R Rinsate Blank-QA Sample P Post-Purge Sample - l d V <br /> M Miscellaneous(e.g.,product sample) Temperature/pH U on Recei t `JJ .�C. <br /> 7 <br /> P P pH `Gust Seals Intact. Yes 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 />