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hXXVN WANY, U.S.A. <br /> P 0 Box 4415, H , TX 77210-4415 <br /> PcKg", <br /> C0RPORATE0 CHAIN O CUSTODY <br /> THE ASSURANCE OF QUAIITY Ja Novato, CA, 11 Digital Drive, 94949 ❑ Huntington Beach, CA, 5702 Bolsa Avenue, 92649 <br /> 415 883-6100 714 892-2565 <br /> Consultant's Name (,tn'1. Page of <br /> L <br /> Address Q© (,� 5-` Site Location 31 0� X , <br /> Project# - 46) - v Consultant Project a Consultant Work Release# <br /> Project Contact Phone# 0/5)30-675� Fax 0 UTA Laboratory Work Release N <br /> EXXON Contact EE ❑ C&M Phone N Fax k EXXON RAS # 3 <br /> Sampled b not Sampler's Signature <br /> Shipment Method Air Bill b [Shipment Date <br /> TAT ❑ 24 hr ❑ 48 hr ❑ 72 hr Standard (5 day) ANALYSIS REQUIRED Sample Condition as Received <br /> Temperature' C <br /> X <br /> Cooler 1/ <br /> Fc t Inbound Seal Yes No <br /> M , ° p Outbound Seal Yes No <br /> in <br /> Sample Descnpisqn, Collection Matrix Prsv #of PACE0 00 A0-0 <br /> 4 Z�(0 0aDate/Time SodlWater Cont Sample# a R¢. a t ! �J fi-�`��I� j���' COMMENTS <br /> Fr W H W W � � F— <br /> 3o S I / + . �' K�4 l5sr � <br /> WOE 30 �' o6" k <br /> LJ U 3 X 3 0 ! 0 7 5- X ►� ! . 3 <br /> l,j D 5 3o S ! /n b"r, <br /> - 3 /a lG -3 x ai z �K s` <br /> /5"13 I3`o X ls�I 81 it I <br /> , L is <br /> 44 <br /> �sG <br /> p A -� 3 tsq1 Is zo.Li - <br /> �S .615 /my k 8 X iso U0 <br /> _ Relinquished by/Affiliation Date Time Accepted by/Affiliation Date Time Additional Comments <br /> VS <br /> 1 W— PO t� t sow <br /> A 61S1-,5-z- / a a <br /> o <br /> �J L� <br /> Distribution White-Original Yellow- Exxon Pink-Lab Goldenrod-Consultant Field Staff ca 7A1,qy � <br /> C, 101y `fir-- 4�2o to DSS 5 d <br />