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hhe <br /> • • Analysisa ofCustody <br /> 0747 L] For Lancaster laboratories use only --7 <br /> �Whee qLoWisascierr Acct.#: / 1� Grou # Sam le#: (��j ■ <br /> p 1 � d� p <br /> Please print Analyses Requested SCR#: <br /> Sfte/Global ID: lh)e Preservation Codes Preservative Codes <br /> f H=HCI T=Thiosulfate <br /> Ste Address: S`1A5 \/11P.1 't l `]Z! , VQ�t(j�� CAQ NE=HNO3 B= NaOH <br /> _ <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC o 5=H2SO4 O=Other <br /> Cn U <br /> Cons ultantl0ffice: D40 Alberto Way,Suite B,Los Gatos,CA 95032 U ❑J value reporting needed <br /> W800 Watt Avenue,Suite 210,Sacramento,CA 95821 c � - ❑HPP Risk Assessment Detection <br /> tt� �T O ❑ "' z <br /> Consultant Pry.Mgr.: CVlll�s5 1eyin i_ U J o Limits <br /> `o o a ❑Chromatograms <br /> Consultant Phone#: - Q to Fax M q�tD'C( ' c�? js" a`� oLa \ <br /> Sampler: I,� � - Y� �� EC I ¢ L <br /> r` co U <br /> az v <br /> co <br /> Field Repeat Top Time New o o = = a w <br /> co <br /> Point Name Matrix Sample Depth Year Month Day Collected Field PtY1N C7 0 H d3 <br /> GA 94 23 5�o Comments 1 Remarks <br /> MvJ- w NN N s 3 i000 NI !1 <br /> w Mw- I w a o+ 3 11-15- 1t15e 5rlicc�. 5e1 <br /> deunw7 <br /> Turnaround Time Requested(TAT)(check box) R ui by: Date Time Receiv -� D to Time <br /> rZ5day <br /> D.TAT ❑24 hour X-* a/ <br /> El ❑ 72 hour ❑4 daily $� f elfin uishe to Time ived by: Date Time <br /> Matrix Values Repeat Values 47 Relinquished by: Date Time Received by: Date Time <br /> S Sr T Duplicate sample Relinquished b , mercial Carrier: ceived by: �atg l <br /> W Surface Water or Groundwater T Triplicate Sample l d O <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedE - Other Q <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g..product sample) TemperaturelpH Upon Receipt I v2.i°C° PH Custody Sea ntact? es o <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1114/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />