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of; <br /> pain of Custod cord -site Time Temp <br /> Project Name Off-site Time Temp <br /> p <br /> BP BU/GEM CO Portfolio: sky conditions <br /> BP Laboratory Contract Number- . yIeteorological Events <br /> Date: Requested Due Date(mm/dd/yy) Wind Speed Direction <br /> Send To: BP/GEM Facility No 7 Consultant/Contractor vy� <br /> Lab Name e,•C-1/7,c Facility Address Vi5 L ztU_ Address <br /> Lab Address Site ID No 6" _G+E#tW , <br /> Site Lat/Long e-mail EDD <br /> alifornia Global ID# Consultant/Contractor Project No i[.1 <br /> Lab PM P/GEM PM Contact -EfConsultant/Contractor Tele/Fax <br /> Tele/Fax ddress f Consultant/Contractor PM , <br /> Report Type&QC Level Invoice to Consultant/Contractor or BP/GEM (Circle one) <br /> BP/GEM Account NoTele/Fax ___]E/GEM Work Release No 0 <br /> Lab Bottle Order No Matrix Preservatives Requested Analysis <br /> Itema r v r, x i Sample Point Lot/Long and <br /> Sample Description Time b Q C Laboratory No, o a:No o <br /> o „ oo N N Comments <br /> J <br /> 3 a z x x x as cn w w <br /> t Mf ��# V <br /> 3 "'1,u- <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 4 <br /> Sampler's Name i Rehngx iahed By/Ambon Date Time Accepted By!Affiliation Date Time <br /> Sampler's Company >7f, _ �s ! f �ti E 11• .� �1 ih <br /> Shipment Date <br /> Shipment Method i 4,; <br /> Shipment Tracking No <br /> Special Instructions <br /> Custody Seals In Place Yes 7,No Temperature Blank Yes No—' Cooler Temperature on Receipt °FIC Trip Biank Yes No <br /> GONSULTANT/CUNTRACT57� BP COC Rev 1 215102 <br />