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• Page <br /> — <br /> 0 bp Chain of Custody Record On-site Time Tem <br /> Project Name9� Off-site Time Tem <br /> BP BU/GEM CO Porttoli:o• Atlantic Riclifaeld Co SkX Conditions <br /> HP Laboratory Conn act Number PtmdSpced <br /> orolo ical Events <br /> Date Requested Due Date(mmldd/yy Direction <br /> Send ToBP/GEM Facility No onsultantlContractor URS <br /> Lab Narne SEQUOIABP/GEM Facility Address 205 N CENTER ST, STOCKTON, CA Address 2870 Gateway Oaks Dr, Ste 300 <br /> Lab Address 1455 N McDowell Blvd Suite D Site ID No ARCO 4493 Sacramento CA 95833 <br /> Petaluma, CA 94954 SL! <br /> L -mail EDD denise ee urscor com <br /> forn�a Global ID# T0607700462 onsultant/Contractor Project No <br /> Lab PM An elee Can BP/GEM PM Contact PAUL SUPPLE Consultant Tele/Faa 916-679-23871916-679-2900 <br /> eleTax 707-792-18651707-792-0342 Address P 0 Box 6549 onsultant/Contractor PM VER <br /> e ort Type&QC Level Send EDF Reports Mara a, CA 94570 nvoice to Consul tant/Contractor o BP/GE axle one) <br /> BP/GEM Account No elelFax 925-299-88911925-299-8872 PIGEM Work Release No Intrim-50441 <br /> Lab Bottle Order No Matrix Preservatives Requested Analysis <br /> w <br /> m <br /> a <br /> a <br /> a L x o o N <br /> Item No Sample E w c m °O °° <br /> Description Time 2 <br /> P P Laboratory No ry Sample Point Lat/Long and <br /> o00 <br /> 3 E o Q Z M F ¢ Comments <br /> o O Z C3 x � F x mut �� <br /> 3 � ¢ z :Dx x � � F- N� <br /> I x X .� <br /> 2 - o 2 xx x <br /> 3 x �C <br /> 4 <br /> 6 x 5 x �c X <br /> 8 OTITAT <br /> g c <br /> 10 <br /> Sampler's Name S Relinquished By/Affiliation Date ime cc to $ / ff on <br /> Sam ler's Com an e 'Q <br /> Shipment Date _ o Q Q C It, t0 <br /> Shipment Method r <br /> 5hi meat Tracking No <br /> pedal instructions Address Invoice to BP/GEM but send to URS for approval <br /> RUN 8260 ANALYTES rN ONE BATCH ANALYSIS <br /> Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt of/C Trip Blank Yes No <br /> Distribulion White Copy-Laboratory/Yellou Copy-BP/GEM /Pink.Copy-Cons ultant/Contractor BP COC Rev 1 1/3102 <br />