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EXXON COMPANY U.S.A. <br /> cc E , <br /> P O Box 4415 Houston TX 77210-4415 <br /> cl 17MIEW* <br /> I N l: 6 R P p R A 7 E t1 <br /> CHAIN OF CUSTODY <br /> TME ASSURANCE OF QUALITT L L <br /> Consultant Name <br />' ® Novato, CA Address lop ' <br /> 11 Digital Drive,94949 Protea Contact t4r &*,p t/a <br /> (415)883-6100 Phone# (y+5 �3I�(���h Fax# 414 --;6C1-0q2--3 _ <br /> ❑ Irvine, CA Consultant Work Release# <br /> Alton Business Park <br /> 30 Hughes St , Suite 206,92718 Exxon Contact [, �, ,r7,u c,N [� Phone# (E(C)) .7;(,h— �g7 Za <br />' (714) 380-9559 Site RAS# <br /> Site Location ` v <br /> Laboratory Work Release# <br />' Sampled by(please print) SOIL WATER <br /> G— e <br /> Sampler Signature Date Sampco on <br /> led w w H e <br /> Sam Collection #of e _ Remarks <br /> da ELCL �= as as °'? Q L <br /> Description Date/Time Matrix Prsv Cant Lu F-W o c ,,, Lu o n F Lu F <br />' "191 <br /> yC> NGr 3 <br /> 1 <br /> Cooler No Relinquished by/Affiliation Accepted by/Affiliation Date Time <br /> �r <br /> Cooler Seal (1 <br /> Intact <br />' V}� <br /> ❑ Yes <br /> ❑ No / <br />' Turnaround Time <br /> (circle choice) _ <br /> 24 hr <br /> hr <br /> 72 <br /> 72 hr <br /> --96-hr <br /> 5 workday <br /> (standard) <br /> Additional Comments <br /> Shipment Method <br />' D I <br />' Shipment Date <br /> Distribution White-Original Yellow-Exxon Pink-Lab Goldenrod-Consuftant Flea Staff <br /> 1 <br />