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Historical Pipeline PonYofid Analysis RequestlChain of Custody <br /> +LawsWr Labor&des2 2 For Lancaster Laboratories use only I- <br /> Vvh&pqjagtyB35flt'� Acct.#. Oroup# Sample#. <br /> Please printrr ss Analyses Requested SCR* <br /> Site/Global ID: V 5 Q( V frJ 7? Preservation Codes Preservative Codes <br /> Site Address: ��i P-0 t�Gt r �j�, n H=HCl T=Thiosulfate <br /> = N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Cons Itan SAIC d S=H2SO4 O=Other <br /> ��fl v`�t. �r <br /> Consultant/Office: ❑39 iTM1 ay- w,___fl__�^� 0 ❑J value reporting needed <br /> El3800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ 65z JNHPP Risk Assessment Detection <br /> � <br /> Consultant Prj.Mgr.: 1�E 5�0V1 w El ❑ J ❑ o Limits <br /> _ <br /> o N N o o M a ❑Chromatograms <br /> Consultant Phone#: S! ��_ -'7L Fax#: /// m � ° U <br /> :? .L] ❑ 65 U OO o <br /> c o <br /> Sampler: 3= � �. ►'7�1 0 �o o 2 M <br /> Z C m N "' U' „' v <br /> Field Repeat Top Time New m o o w mco co <br /> = _ co za w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN 0 U m o- <br /> f 7g-03_03 13ST Comments t Remarks <br /> 9.S'20 _v3 33 S'3 k <br /> S — f S` -0L <br /> g$—C4� Zo . ( ?� <br /> S S �o3-ter 7 f 7c x <br /> 1. S, <br /> Relin ed by: date Time Received b Date Time <br /> Turnaround Time Requested(TAT){check box} �C.ZO/ Tie <br /> STD.TAT ❑ 24 hour ❑48 hour <br /> ❑ 5 day ❑ 72 hour ❑4 day Relinquished by Date Time Received by: Date Time <br /> Relinquished by: Date Time Recei2y Date Time <br /> Matrix Values Repeat Values <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: ceived b /f Dat Time <br /> W Surface Water or Groundwater T Triplicate Sample ii <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS F701F, Other '(�/ / +P.� f( v <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g..product sample) Temperature/pH Upon Receipt �r 3__1C1 pH CustQ4Seais Intaet Gds No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1/14/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />