Laserfiche WebLink
Historical Pipeline <br /> Ponlbfio Analysis RequestlChain of Custody <br /> Lancaster Lab={ ies 2 r/? �( ? For LancasterLaboratoriesuse only f 9C;)3 <br /> � "�2 <br /> Me 6ascknce. L"3 3 7'J Group#1 j �130� Sample#: .�3 CD C;)3 �f y <br /> �at►tY Aoct.#: <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: — Preservation Codes Preservative Codes <br /> Site Address: �� 1�✓ , 1a l C H=HCl T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Majisholt Lad Consul nt:SAIC m S=H2SO4 O=Other <br /> / � U <br /> Consultant/Office: n"" J' <br /> ❑J value reporting needed <br /> ❑3800 Watt Avenue,Suite 210,Sacramento,CA 95821 c � - <br /> HPP Risk Assessment Detection <br /> VV <br /> ir} J ,I i U ❑ ❑ El ,,, Limits <br /> Consultant Prj.Mgr.: V" ' rl 551011 f F1 0 w � <br /> o N ❑ o� �o ❑Chromatograms <br /> CD <br /> Consultant Ph o #: Fax#: 0 Wco <br /> ❑ o o <br /> 1_ � o <br /> Sampler: �'I �l r r" E l N N S M M <br /> d Z co co CV <br /> co <br /> co <br /> Field Repeat Top Time New o o w m i = _ w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN U m a <br /> Comments!Remarks <br /> Turnaround Time Requested (TAT)(check box) Rel' i by: `fD to Time Receive Date Time <br /> STD.TAT El hour El 48 hour <br /> ❑ 5 day ❑ 72 hour ❑ 4 day eiinq ! Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time ecei ed by: Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Recei ed y: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample ��, <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS F<gx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt �- Co pH Cust y Seals Intac Y0s No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 vv 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 />