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HisloticalPipeline ' 1 1 1Analysis RequestlChain1Custody <br /> +L-ar �LabOraLQ�Ies 2r� '� For Lancaster Laboratories use only <br /> vt9x�reciabtyisaxk xe. G 7 ( � � `'i Acct.#: Group# j I S 3�o O Sample#: <br /> Please print Analyses Requested SCR#: <br /> Site/Global!D: e <br /> Preservation Codes Preservative Codes <br /> H =HCl T=Thiosulfate <br /> Site Address � a N =HNO3 8=NaOH <br /> 2 <br /> ChevronTexaco PM:M.Scott Mansholt Lead onsultant:SAIC _ m S=H2SO4 O=Other <br /> CcnsultanUOffice: ❑//401 Alberto Way,Suite B,Los Gatos,CA 95032 r a ❑J value reporting needed <br /> EIG800 Watt Avenue,Suite 210,Sacramento,CA 95821HPP Risk Assessment Detection <br /> O imits <br /> Consultant Pry.Mgr.: 1 CZ Ir L,1_ w ❑ ❑ o <br /> o Z74 ❑Chromatograms <br /> 0 0 <br /> Consultant Phone#: — 38—_7�T, 5 Fax#: co o inEl <br /> Q �, <br /> p 0 <br /> Sampler: Al � � ,LLf K--� n N o o <br /> 0 Z m m N g 'S U <br /> a � O O O J <br /> Field Repeat Top Time New o o w M = = _ a- w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN O U m E F_ g <br /> AA 10-3 - — b 7 157 t _ A X7 Comments!Remarks <br /> Turnaround Time Requested (TAT](check box} Relinquished by: Date Time ecei by: ate Time <br /> y( TD.TAT ❑ 24 hour El48 hour 71rdf 131 <br /> El 5 day ❑ 72 hour El 4 day Relin uishe y: Date Time Rec d b Date Time <br /> � Q <br /> Matrix Values Repeat Values Relinquis by_ Date Time c Date Time <br /> S Soil D Duplicate sample Relinquished by C mercial Carrier: Recei by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample R <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS ;d JE Other D ^.+ <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt �ti`�i C° pH Cu dy Seals 4inta No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 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 />