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Historical ' • ' P• • ! Anal)-sisRequestlChainofCustody <br /> +L.amaster Umbies 2f){� 2 For Lancaster Laboratories use only �} q <br /> lh cj tiyisasdence. Acct.#: II T IJ Group# I &7?2-0- :)—Sample#: 567 <br /> Please print 1�c � $ Analyses Requested j SCR#: <br /> Site/Global ID: _ I Preservation Codes Preservative Codes <br /> Site Address: a H=HCl T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> CU <br /> ChevronTexaco PM:M.Scott h4ansholt Lead Co sultant:S IC I S=H2SO4 O=Other <br /> Consultant(Office.�X ` OJ value reporting needed <br /> ✓]3800 Watt Avenue,S it 210,Sacramento,CA 95821 a HRP Risk Assessment Detection <br /> r U 0 m w Z imits <br /> Consultant Pri.Mgr.: W ,7/- — �_ 0 —' o O <br /> 0 �, ❑Chromatograms <br /> ff r r H o O U U <br /> Consultant Phon 7 J ax#: m aQ o <br /> Sampler: /� y :3 <br /> 0 <br /> Z ib co N "' <br /> Q- 00 o o m <br /> Field Repeat Top Time ue.. o o w m i _ = a w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN C7 U +- m a <br /> Comments!Remarks <br /> a <br /> Turnaround Time Requested(TAT)(check box) Relinquis Date Time eived by: Dat ff Time <br /> ;STD.TAT 0 24 hour 0 48 hour <br /> 0 5 day E372 hour ❑4 day Relin hed b : Dat Time Received b� p jam' Date Time <br /> 442,i7df 166- <br /> Matrix <br /> 663Matrix Values Repeat Values Relinquished by: Date Time Receive Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Rec i byDat Time <br /> W Surface Water or Groundwater T Triplicate Sample _j <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS Fd Other b <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Reoeipt/.CR 7, In pH ustody Seals Intact? Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,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 />