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Lar � LabOrIQ�Ies 2 2 1 [ For Lancaster Laboratories use only <br /> GL J r �" y � � <br /> Whert?�tyisascier Acct.#: { Group# d S-7LU'5 Sample#: 5 u L4 3Q5 I <br /> Please print A Analyses Requested SCR#: <br /> Site/Global ID: — v� Preservation Codes Preservative Codes <br /> �i��7 �P f���s ` H= HCI T=Thiosulfate <br /> Site Address: I C N=HNO3 B=NaOH <br /> ChevronTexaoo PM:M.Scott Mansholt Lead Consultant:SAIC co <br /> S=H2SO4 O=Other <br /> E2 U <br /> Consuttant/Office: 4@ rfMte a os, Y �► C� c J value reporting needed <br /> EqHPP Risk Assessment Detection <br /> ❑38�00W/ap Avenue, uite 2]1✓0,Sacramento,CA 95821 U 9 Limits <br /> Consultant Prj.Mgr.: 1N r! �I�y�1 I\ ❑ J <br /> O N El ❑Chromatograms <br /> Consultant Phone#: 7` l6 Fax#: a co a <br /> E U O <br /> Sampler: !�!l�I� �' 0 :3 N <br /> Q Z 0 o <br /> Field *Repeat Top Time New o w =Point Name ample Depth Year Month Day Collected Field Pt YM c7 UQ- la— <br /> © d l Comments 1 Remarks <br /> �+ 0'7 <br /> 12, <br /> 557 ,- W o <br /> -� o � <br /> n�)o <br /> Turnaround Time Requested(TAT)(check box) Reli ishe by: Date Time Received by: Date Time <br /> STD.TAT ❑ 24 hour ❑ 48 hour <br /> ❑ 5 day ❑ 72 hour ❑ 4 day elinqui ed Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Rec d by: Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: R ed b Date Time <br /> W Surface Water or Groundwater T Triplicate Sample / q- ! A . <br /> TTrip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt((__ C° es pH Custody Seals Intact? No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box'f242 ,LanZcastxe�r PA 17605-2425 (717)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 />