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i r o. i ` ` i � iii <br /> . __.. <br /> . ... . ... . . <br /> .. ... <br /> pSter <br /> ra <br />' � U...... t.. <br /> � For Lancaster Laboratories ttse only. <br /> � Wf1er ualascrrice. <br /> Acct #�:,: Group#.. Sample#: . <br /> Please print SCR#:'. <br /> Analyses. tequested <br /> :Site/Global ID: ( ;'` s / °. ,i. t,' } _'. rI. f.. l�reservatinn'Cades Preservative Godes <br /> Site Address. :. � i� ',.> , FI HCI 1 7hiosulfate' <br /> a <br /> iV =}iNO3 B= NaOH <br /> ChevronTexaco PM:M.Scott Mansholt dead Consultant;.SAIC1 I w S=.H2SO4 O=Other <br /> 0 <br /> ConsiiltanflOffice ❑401 Albertd Way,Suite l3,Los Gatos,CA 95032 c� ]❑J value reporting needed <br /> >v <br /> �. s <br /> 3800 Watt,4venue,Suite 214,Sacramento,CA 95821: c u �: . I PP Risk Assessment Detection <br /> E o ❑ v, <br /> Consultant Prt Mgr.: t V i`> i, t ii U n =; L€mats. <br /> rr ° �a W ` ❑Chromatograms <br /> Consultant Phone#: r? .:i { _ Fax# ;1 {<;: t 's ca ra'< U .:; , <br /> n <br /> Sampler * t t1f r ,' s�` ' P?t° m a ¢ ` <br /> �:_ Q. 4 m :�[ ti j I fys .Ve : <br /> Field Repeat Top _ Time New o. c 111111]]] _€ f 7 ''t , 11 <br /> o ¢ : c a cA€ tt;�E <br /> Point.Name Matrix Sample Depth Year Morith lay :Callected Fia€ciPtYIN 0. U 1 a : F- F " .. ,, ; <br /> /; t ` Comments 1 Remarks ! <br /> 1 ,... . �A w:-:i �:..� YV: . , . . .. . ..:. ...4f .. x: : - .� .. .. . J� . ..... . �N'f,;;,Y__Z_n t. . .j , (.,, . <br /> u <br /> \' `, '° I f. is <br /> y9 <br /> r %� f ' <br /> .. ..... ..... .rl `. ,::` i .s <br /> ,.t>,. t.,., <br /> f <br /> r <br /> .. ' ; <br /> f t f. <br /> 9 <br /> 7 �, :�:< m i''� - <br /> r . <br /> w �::a111. <br /> Turnaround'ftme Requested (TAT)(check box) Reli uisied by: Gate lime Received..Eay t» ' Date T€me: <br /> STD.TAT ❑ 24 hour 48 taour }� 4a ), t R,� ,: E " � <br /> ❑ 5 day ❑ 72 hour ❑4 day ` " el€n u€shed by: m [rl�ate Time Received by Date Time <br /> ,u <br /> Matrix values Repeat;;llalues;` <br /> Rel€nquished by: Date Time Received by. Date s Time <br /> S Sail D Duplicatesample Rei€nquished by Commercial Carrier Rece€ved by: Dato Time <br /> W Surface Water.or,Groundwater T TriplicateSample;, <br /> T Trip Blank-QA,`:Sample `.: fd Pre-Purge Sample': UPS FedEx Other <br /> R Rin5ate Blank-GA Sample P Post-Purge Sample <br /> M Miscellanaous{e g product sample) Temperature/pH Upon Receipt .. pN Custody Seals Intact? Yes .` No <br /> Lancaster Laboratones Inc.,2425 New Rolland Pike,PD Box 12425 Lancaster,PA:17605-2425 {7.17)556 2300 4324.01 Rev. 1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink'!copy should beietained by the client. I <br />