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Historical r 1 + 1 1 • AnalysisRequestlChain1Custody <br /> Lang LkOlW'iles 10 4 8r For Lancaster Laboratories use only '' }} ! <br /> VVIwec rtylsa5aenre. Acct.#: r i Group#/I G.55?:5 Sample#:-6`7�dO I q g <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: V; _ Preservation Codes Preservative Codes <br /> H=HCI T=Thiosulfate <br /> Site Address: 7iSr7'�� u✓_Pay N=HNO3 B= NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIL S= H2SO4 O=Other <br /> ;n <br /> ConsultantlOffice��J � � ❑J value reporting needed <br /> - Y PP Risk Assessment Detection <br /> ❑38�0n0/Watt�vernaA��ra ento,CA 958� �CW, U ❑ w Limits <br /> 9 y" rrl r ❑ o <br /> Consultant Pr'1.M r.: f9tn/� <br /> y o N � � ❑Chromatograms <br /> Consultant Phone#: `/ Fax#f. w ,o o <br /> X o <br /> o 0 <br /> Sampler: f a z � N o <br /> Field Repeat Top Time New m 0 0 _ co <br /> U !o <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN O m a <br /> 501-19y T TU 0 1010- <br /> Q 0y X1 X I I Comments 1 Remarks <br /> 5 - 4/ 37 05 og 14/ 10 �0r Sara;0i° 53 di <br /> a 'V AJQ o i I X30 Sw/ vn <br /> 411, Srq Cq 10 1 LX <br /> S ) 1V10 Y. X 1 <br /> 1 <br /> 0 <br /> sY. <br /> s y <br /> s - 01X IX <br /> Turnaround Time Requested(TAT}[check box} Rel' ulshed by: J Date Time Received by: Date Time <br /> STD.TAT 1124 hour El 48 hour &/❑ 5 day El 72 hour El day inqui d by: Date Time Received by: Date Time <br /> seon <br /> Matrix Values Repeat Values 9 0 <br /> Relinquished by: Date Time Re ed by: Date Time <br /> 1 <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: ecei d y: Datq Time <br /> W Surface Water or Groundwater T Tdpiicate Sample <br /> T Trip Blank-GA Sample N Pre-Purge Sample UPS 0 E Other �{ of <br /> ` <br /> R Rinsate Blank-QA Sample P Post-Purge Sample U� <br /> M Miscellaneous(e.g..product sample) TemperaturelpH Upon Receipt 1, 5 C° pH Cust y Seals Intact? No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 97605-2425 (797)656-2300 4324.01 Rev. 1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />