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k EXXON COMPANY, U.S A <br /> P 0 Box 4415 Houston TX 77210 4415 <br /> P. <br /> R C O R A 0 R A t f 0 <br /> CHAIN OF CUSTODY <br /> =>tC LSSu�L>,CI Ol DU�IIIT <br /> "y Consultant Name 1 <br /> ❑ Novato,CA Address 00 <br /> 11 Dlgnal Drive 94949 ProKK3 Contac CC bS Pro ect p 41 - <br /> (415)883 6100 Phone N �/r �" Fax# / 3 L94123 a <br /> ria ❑ Irvine,CA Consultant Work Rolease it <br /> Alton Business Park <br /> 30 4ughes St , Suite 206,92718 Exxon Contact 0 Phone a <br /> (714)380-9559 Site RAS 11TZ -3330 -- <br /> d S4te l-ocabon <br /> Laboratory Work Release it , <br /> Sample by{ lease print) <br /> i <br /> SOIL WATER <br /> Sampler Signature Daae Sa/m�pled w <br /> a Sample Collection N o1 $ 'i o� "¢ Remarks <br /> Description DatefTime Matnx Prsv Cont f`-w ,,, w 1. b a w a <br /> loss <br /> /1= 5 FqTe 7 I ✓ ! D5S <br /> 040 OZ /d �� S q$ S-7.7, <br /> Cooler No Relinquished by/Affiliation Accepted by/Affillation Date Time <br /> Cooler Seat <br /> Intact ' r <br /> O0 <br /> Yes �I� —i---• <br /> © No <br /> Turnaround Time <br /> (circle choice) ••c <br /> 24 hr `r <br /> 48 ht <br /> 72 hrr- <br /> 96 <br /> workday <br /> (standard <br /> Shipment Method Additional Comments Job #41101 D,SV7 <br /> Shipment Date ��f#15 C��9 7 0� Q 0r � ��1 Z. <br /> Distribution White Anginal Yellow Exxon Pink Lab Goldenrod Consultant Field Staff <br /> 0 <br />