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,vin,al Pipelineslid • f t • • <br /> +Lmcaster.Ulaabyz 0132 4 For Lancaster Laboratories use only ` Q e <br /> 1MtlifyS a scienc@• Acct.#: r Grou # Sample#: 'JS 7��7 Q <br /> 5 _ p <br /> O --�� <br /> Please print v Analyses Requested SCR#: <br /> Site/Global ID: Preservation Codes Preservative Codes <br /> fA .J C H= HCI T=Thiosulfate <br /> Site Address: 66 <br /> N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC _m S= H2SO4 O=Other <br /> E2 U <br /> Consultant/Office: 0 40 Alberto Way,Suite B,Los Gatos,CA 95032 c 8- a QJ value reporting needed <br /> /31300 Watt Avenue,Suite 210,S to,CA 95821 c 11 '• aZ ❑HPP Risk Assessment Detection <br /> O <br /> ^ � o U <br /> Limits <br /> ConsuItant PMgr.: w ❑Chrom <br /> atograms" <br /> FCConsultant Ph #:/,6 ! 9��1 <br /> 17 <br /> Sampler. r A� rerG in o <br /> Z CN co N Lo Ud- 337 U <br /> to <br /> Field Repeat Top Time Hew m F 0 x m i = = °° a <br /> Point Name Matrix Sample Depth Year Month Day Collected Field rt YIN C7 U H a' LLI <br /> m a <br /> Comments 1 Remarks <br /> Tu r d Time Requested(TAT)[check box] Relinquishe Date Time R i ed Date Time <br /> STD.TAT ❑ 24 hour ❑48 hour f I - . 3Za 71`7/ ,3 M <br /> y ❑ 72 hour ❑ 4 day R in €she by: Ranee Time Re 'ved y7/ 1930 � Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished;�ejd <br /> mercial Carrier: Received by: Date `Time <br /> W Surface Water or Groundwater T Triplicate Same <br /> T Trip Blank-QA Sam pie N Pre-Purge Sample UPS Other gas <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt -P Custody Staal,Intact? es 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 />