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I <br /> �0 :5a' <br /> SHELL OIL PRODUCTS <br /> COMPANY CHAIN OF CUSTODY RECORD , <br /> i <br /> Results o: <br /> 1NIC OR`FAGfb tY Date: p Consult. of... <br /> Page <br /> �' r • ' C 5S. ! Setect one only <br /> Sife A�&e9s " �� ri , _•�� ,r .ti:.�, ` ,'� C Q Site Invest(4441) O Wtr RernlSys'(n <br /> 4. <br /> i , <br /> Cr}iisl`'itza'N�l bntr ct� ^[s p Soll CIaslDisp(4442} G.W.Monitor( t3 <br /> , ^. <br /> TURN AR0�7N�-TIME Select one only; � <br /> ,, Q Wtr;CIaslDisp(4443) O her <br /> .S `O 24 hre..Q 48 hrs.Q 15 dayi;1Nomnq Q'OtheC <br /> O 5o111Air Rer�1$ys(4452) <br /> r 'st�rt7lrrie ;` r AnaluSis Required <br /> M' <br /> SAMP4E MATRi� Select one only <br /> } Neer ; (milftary) .. N 4 <br /> _ o cv Water d N,4PL Q Sludge Q Sedgy ' <br /> Y�s411 ,sl. �' m ` <br /> }•c��<•> a e,..' c —', Q.3olj. Vapor'. Q Bedrock Q Ot})el } <br /> Ea¢ 0_Lbi". <br /> X � � vQ LAB USE ONLY: .. <br /> UST r E c d m F ry a a $ N a Lab Tracking No.: <br /> Agency Sample Time y � s Z m v <br /> M- <br /> x a w 3£ x <br /> Field Sample ID U w _ <br /> (military) 0 � � u, � = � D_ �' V 4 � s .. <br /> F- <br /> 0 c a Com F a d a o: a �, v Sample ConditionlCammants <br /> \ ti' 1-, 17: <br /> 3 ; i <br /> Cooler Temperature: <br /> U':' i Material Description <br /> Relinquished By(slgnatur ): Printed Name: Date: P Receiv d By(sign e: Printed Name, Date: <br /> \ _ �_n Time: I''lam, (/ Time: <br /> i Relin h y1gri re): Printed Name: Date: /� Received By(signature): Printed Name: Date: <br /> v / 6 <br /> Time: Time: >" <br /> Rr iuished Bly(signature): Printed Name: Date: celved By(signature): Printed Name: Date: kL <br /> Time: 1 , N�rc J £� <br /> THE LABORATORY MUST PROVIDE A COPY OF THIS C AIN OF CUSTODY WITH INVOICE AND RESULTS RE SED(k.;wbvCu5VT00y <br /> 12197 Ij:. � <br />