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. Fox .c2S of Lab Report and COC to Chevron Co ct• ❑ Nov Chili -Of—CuSf —Rec&d <br /> Chevron Facility Number 9-5075 Chevron Contact (Name) �TammyHodge— -- <br /> Faofll4y /lddreae <br /> 2405 Airport Way, Stockton, C . (570) 842-8725 - <br /> ,�. (Phone) <br /> Chevron U.S.A. Inc. "r_ <br /> P.�. ��X 5004- Consultant Project Number � � �`-�� Laboratory Nam* Sequoia <br /> Consultant Ham. Blaine Tech Services, Inc. 1 590 <br /> 985 <br /> San Ramon, CA 94583 c Laboratory Rslsasw Number /dress Timothy Or. , San Jose, CA 951.!3 Somples Collected by (Name) <br /> FAX (415)$42-9591 Jim Keller <br /> Project Contact (Name) Collection nota <br /> (PhoncyLOR �`� ��`_(Fox Number)M-19-3-87J-3— Signature <br /> Malyese To Be Performed ` ✓ J <br /> - no NOT BILL <br /> 2U a� o <br /> F E P FOR TB—LB <br /> g <br /> Oa. <br /> rt <br /> } b Llj 00 nil ON �� �n <br /> r �e pp <br /> E 's 1 • 1 v n o u r1 1Co two Q.a nw y °� <br /> E A E 1 E e <r s m r y SSSYa _P°a ,a ,� a tl <br /> �i z' tn r h' y'{ u b a a S �.'tRemarks <br /> Mw' -3 ' - <br /> �w, s 3 sC <br /> a Rellnquleh By gnoturs) Organl:otlon Dotw/nime�r/C Rene d BY (Sl re) Qrganlxatlon Dote/Tlm./�I,/ Turn Around 7{mw (Circle Choice) <br /> 24 Hre. <br /> Qratlon Organization nate/ilme 48 Hrs.Rdl <br /> / 5 <br /> t0 Days <br /> �qulshed By (Signature) Or anl:atlon nate/`nmo Rscleved For Laboratory ny (Stgneturo) Oats e 12 <br /> CA Contraotwd <br />