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page_,.,_,of <br /> bp Chain of Custody Record Oa�siie T'ane: Ji'�� Temp:, <br /> -' <br /> - Project`Name f.{3�{ Off-:tate 'lima;- 5jp W' 7'bmp: <br /> BP BU/GEM CO Portfolio_ 111 S 0l0 slti'Conditaoas: <br /> BP Laboratory Contract Number. xr0logical l vena: <br /> Date:J a -n Requested Due Date(mm/dd/yy) owt £ wad Saccd: lrec4on: <br /> �. <br /> Send1o; GEMFacility No.: onsuitaaVCon actor <br /> Lab Name: '(� P/GEM Facility Addrrss: o ., o - LA-oS 'dress (,� <br /> Lab Addy=%: e f `l Site ID i o. Lb i <br /> . itc Lata ng: diem <br /> . <br /> California Global LD#: taat/ContrsewProjectNo.: <br /> Lab PVI: FL D PIGF.M PM Contact: osultanticontractor TcicyFex: <br /> l:lelFax: p ss: oasvltanticonrraetorPM;VP- TJ <br /> xcpan'Iypc&QC Level: voice 4o: COWL'a mt/Coatraelor'or BP/GEM (Circle one) <br /> BPlGEM Account`Io,; elelFax: q'� e�. ?� /GFb.Work'Relr*No:' <br /> Lab Bottle Order No: Matrix 1'resenvtives Requested AvItY,49 <br /> b 9 <br /> Item o „, a N m Simple Pdiat LatUttg aid <br /> Sample Description Time :4 Laboratory No. $ a f* $ <br /> Na. o S Comment% . . <br /> L 13— il:Lto K ►1 P — — <br /> 2 6~� lt:kS by <br /> s <br /> 5 p }dos �X/ n•� t ' <br /> 5 <br /> 71y 07 <br /> 9 Dom- rz,3o a t 'G <br /> Sampler's Name: t2,Iktj (15gp i Rclloqulsbed Hy fAfaWtbn t, TIM cepted By I Alli fi6a Dau JTIwt <br /> sampicr's Company: r 3: tt4z:o <br /> Sbipment Date: -p <br /> Sbipmcnt Method: p <br /> ent Tracking No_ y 12ST 0 2Jr�a ' h255 <br /> ial Tnstraetionx; <br /> Seals In Placc Yes No Temperature Blank Ycs�No Cooler Temperature on ltccc p[ QV!C Trig BLmk Yes____No— <br /> LABORATORY HP COC Reel 215MZ <br />