FIELD DOCUMENTS - Laserfiche WebLink

Home Browse Search

Historical Pipeline PonYolto Analysis RequestlChain of Custody AK-ancaster��odes ®1o5 For La a ter Laboratories use only L� ``-7 + )��Yisa science. Acct.#: Group# j j,l n Sample#: "t 1�� `7 _I V P Please print Analyses Requested SCR#: Site/Global ID: mS L -r 57f0 aY03 Z Preservation Codes Preservative Codes Site Address: Rig H= HCI T=Thiosulfate cc N= HNO3 B= NaOH ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC W S= H2SO4 O=Other i U ConsultanVOffice: 11401 Alberto Way,Suite B,Los Gatos,CA 95032 ca xi ❑J value reporting needed 3800�Watt Avenue,Suite 210,Sacramento,CA 95821 o El , z El H P P Risk Assessment Detection Consultant Pd.Mgr.: (%n f! 5 Z"`Yi L 5 U El ❑ > [ 0 U Limits p � a ! -7 C? o o -a ❑Chromatograms Consultant Phone#: '1"[./0 ' 77 C� Fax#: ! / � 3 S (D C, o o El Elrn o 0 0 SC. ampler: �/T ca � N co Q. Z m m c� 00 O O J Field Repeat Top Time New 2 o '< m co Point Name Matrix Sample Depth Year Month Day Collected Fleld R Y!N U H m a VA r 0 Commenfs!Re arks e S'.� G� / c..� e Turnaround Time Requested (TAT)(check box) Relinquished b Time eceived by: Date Time ❑ STD.TAT ❑24 hour &48 hour El5 day El72 hour El4 day ed by: D to Time Received by: Date Time Matrix Values Repeat Values Relinquished by: Date Time Received by: Date Time S Soil D Duplicate sample Relinquished tial Carrier: ce ed by: t Time W Surface Water or Groundwater T Triplicate Sample T Trip Blank-QA Sample N Pre-Purge Sample UPS Fed x Other i R Rinsate Blank-QA Sample P Post-Purge Sample M Miscellaneous(e.g.,product sample) Temperature p Upon Receipt o;2<< C. pH Custody Sea In ct? Yes No Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2304 4324.01 Rev. 1114/05 Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client.