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of <br /> Chain of Custody t?cord rSky <br /> ite Time Temp <br /> b Project Name -- CO q nl site Time Temp <br /> PPM BP BU/GEM CO Portfolio: onditions <br /> BP Laboratory Contract Number• orological Events <br /> Date: j �a `0 ` Requested Due Date(mm/dd/yy) lO d} 1 Speed Direction <br /> Send To- E-Ck J O l BP/GEM Facility No Consultant/Contractor 5 EC-0 <br /> Lab Name BP/GIM Facility Address /G e W S c� Address 30341 L 0 E c� <br /> Lab Address Site ID No <br /> Site Lat/Long -mail EDD <br /> California Global ID# onsultant/Contractor Project No 7 Z c{g W.p 3 <br /> Lab PMHP/GEM PM Contact eAIL onsultant/Contractor Tele/Fax 156t- OL[ <br /> TelefFax Address <br /> onsultant/Contractor PM VJNiJ..Ar4Ke�irc <br /> Report Type&QC Level Invoice to Consultant/Contractor !r- /G (Circle one) <br /> BP/GEM Account No elelFax P/GEM Work Release No <br /> Lab Bottle Order No MatrixPreservatives Req`uyested Analysis <br /> y^r 4 <br /> V b <br /> d <br /> INS Sample Deseriphon Time a No No o o $ Sample Point Lat/Long and <br /> w °O eq Cq Comments <br /> 0 aQa, <br /> 1 53$ <br /> 3 <br /> 4 .. <br /> 5 Nr s-1v <br /> 6 - <br /> 127 <br /> 8 <br /> 9 <br /> 10 <br /> Sampler's Name Sr Re lie AtIDlaLon lase ce d By/Attiliation ate i®e <br /> Sampler's Company S'E�G SE��G< <br /> Slit mean Date A ,e E <br /> Shipment Method r o -' 14 <br /> Shipment Trackuig No <br /> Special Instructions. <br /> Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt °FIC Trip Blank Yes No <br /> LABORATORY BP COC Rev 1 2/5/02 <br />