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Historical Pipeliner1 • • AnalysisRequestlChainofCustody <br /> Lancaster Ll"1025 2 214 For Lancaster Laboratories use only j t <br /> f I_, j Sample M L+`4 3DL &—9D <br /> V vreq abl lisasCiefTCC. Acct.#: 1 ) # Group# 0 to`1 p <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal ID: Preservation Codes Preservative Codes <br /> H= HCI T=Thiosulfate <br /> Site Address: N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott a holt Lea Consultant:SAIC S=H2SO4 O=Other <br /> ConsultantlOffice: I/J/ I 93��© "2 J`!fir ❑J value reporting needed <br /> ❑3800 Watt Avenue,Suite 210,Sacramento,CA 95821 � � - <br /> PP Risk Assessment Detection <br /> ��I' f .y U ❑ 0 - Limits <br /> Consultant Pd.Mgr.:w �I 1h/I/L w J 7" - <br /> o N 0 ❑Chromatograms <br /> Consultant Phone#: Fax#: a) 00N o <br /> / m o <br /> Sampler: <br /> Q Z °° 00 <br /> N o <br /> Field Repeat Top Time New o o <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN C7 U m <br /> 0170 Lg/,5 <br /> x Comments 1 Remarks <br /> Q <br /> (2, JS t <br /> Turnaround Time Requested(TAT)(check box) Inquishe ]e- / i to Time Received by: Date Time <br /> V lQD <br /> �(STD.TAT ❑ 24 hour 1:148 hour WX <br /> El day El 72 hour ❑ 4 day Relinq shed b . Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Received by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> - <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt 1.b C° pH Cus ody Seals Intact? �es 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 />