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of <br /> — <br /> Chain f CustodyVcQlyd Freteorological <br /> Temp <br /> Project Name f' r �-1 < ' �- e Temp <br /> 0 p <br /> BP BU/GEM CO Portfolio: on <br /> ` BP Laboratory Contract Number: Events <br /> Date: Requested Due Date(mm/dd/yy) • - Direction <br /> Send To: _ L " -7 P/GEM Facility No �r > I <br /> onsultant/Contractor <br /> Lab Name P/GEM Facility Address « 4 ` u ddress L Y �,E 77*77 <br /> Lab Address Site ID No ' �.. , �Y -.77, <br /> c.4-- <br /> Site Lat/Long mat]EDD <br /> California Global ID# / Consultant/Contractor Project No 7 277, <br /> Lab PMBP/GEM PM Contact '�"-r ,tir•' E onsultant/Contractor Tele/Fax 'c"1 of <br /> Tele/Fax <br /> Address Consultant/Contractor PM ' 7 / �H <br /> Report Type&QC Level voice to Consultant/Contractor oZ B EM (Circle one) <br /> BP/GEM Account NoTele/Fax P/GEM Work Release No <br /> Lab Bottle Order No Matrix Preservatives ti Requested Analysts <br /> yr �ti ti J <br /> Ite <br /> Y 1m Sample Descripton Time 'bR ; l <br /> -` Sample Point LatL <br /> ong and <br /> No. x <br /> 00 Comments <br /> 00 00 <br /> 60 <br /> '7/7, <br /> 2 <br /> 3 v 1 3 <br /> 4 <br /> l•� ' J , <br /> 6 ft ! JJ Zr3� V <br /> 7 <br /> g <br /> 9 <br /> la <br /> Sampler's Nam /'- Rettnyuhhed By JAffl istion <br /> ate- rime c e Led By/Atriliation , Date IMP <br /> Sampler's Company 5 t <br /> Spment Date f j ' ' <br /> Shipment Method , <br /> Shipment Tracking No <br /> SpectalInstructions <br /> Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt °FIC Trip Blank Yes No <br /> -I 1 11 TAAI ! RITDA <br />