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W1 %'U01VUY <br /> L"W �1 l <br /> Les 0302 For La?TS <br /> star aborator'ies use only <br /> mem issascence <br /> { Acct.#: #_ tilq� —Sample <br /> Please print D � � '~�n f�� r f o GroupAnalyses Requested SCR#: <br /> Site/Global ID: Q _ Preservation Codes Preservative Codes <br /> Site Address: . H= HCl T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> ChevronTexaeo PM:M.Scott Mansholt Lead Consultant:SAIL y U S= H2SO4 O=Other <br /> Consultant/Office: El 401 Alberto Way,Suite B,Los Gatos,CA 95032 ❑J value reporting needed <br /> ��1s,� a800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ElElHPP Risk Assessment Detection <br /> /� z Limits <br /> �� <br /> Consultant Pd. Mgr.: U ❑ ❑ J ❑ uu U <br /> 16` "� ` 1 Fax t7 — "" .� o o � W ❑Chromatograms <br /> Consultant 11.t <br /> -nem#: W c 0 o <br /> Sampler: [�(� C Zi G�� 4f Cs''p/S/ �' EEl El D 0 0 0 M <br /> a Z `g °�° o <br /> Field Repeat Top Time Now o m in °O Q <br /> Point Name Matrix Sample Depth Year Month Day Collected rieid Pt YM (9 U 12 m - a aLLJ <br /> 9- 1 V7 �� �� Y Comments 1 Remarks <br /> � 1 - .-tom •��] <br /> S 3 0 <br /> 0 - <br /> N <br /> - _L <br /> 4 V M IY <br /> I FFFFI I <br /> Turnaround Time Requested(TAT)(check box) tRelinshed <br /> b Date Tim Received by: D le Time <br /> STD,TAT ❑ 24 hour ❑48 hour �D" <br /> ❑ day ❑ 72 hour ❑ 4 day by: D e Time Receiyp to Time <br /> Matrix Values Repeat Values hed b : ate Time Received by: e <br /> S Soil D Duplicate sample <br /> W Surface water or Groundwater T Triplicate Sample Relinquished�FedEx <br /> ial Carrier. Received by: Date Time <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sampleoft <br /> M Miscellaneous(e.g..product sample) Temperature/pH Upon Receipt __ _pH Custody ntact? 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 />