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SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Dare rz�Z 4l 7y <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No Page of � <br /> Slle Address <br /> 77 4��v,f�r G��� �1��� f�vr (t d.2 Analysis Required LAB < ver <br /> WICa — - _ — — - -- — -- _ <br /> CHECK ONE(1)BOX ONLY CTrDT TURN AROUND TIME <br /> Shell Engineer Phone No GIN Monlloring ❑ 4461 <br /> �r\ 511e Investlgallon .r6441 <br /> Fax ur24�or"6 v❑� <br /> ✓� e... _ r 1 aX 4B hos U <br /> Consultant �1a�me 8 Address I ,r �- a Sal Classtly0sposal {� 4442 <br /> L(}aI �c� 0 Weror 15 day, (J (Normal) <br /> r�J O <br /> —� ___ _ ___ ClassttylDlsposal LJ 4443 <br /> Cons tanl Cofilact Phone t!o (416 _ ill Olher <br /> IZ'Zr r t1 m O I-- SolVAlr Rem or Sys <br /> 5U)ZIk rrr N In Dam L] 4452 <br /> �n,!�r��l•. I Fax # 7.t 7g 3p 2 m N ad <br /> Comments — _ — 0 O °° 1+orE Nally Lab as <br /> N Q Ui Water Rem or Sys soon as Possible of <br /> n- 0 O&M U 4453 24148 hrs TAT <br /> Sampled by - ,n ,o N U m m Dtner ❑ <br /> 0w co co a d o r UST AGENCY <br /> Printed Name ,r ,` j -�,— -- a- 4 w U a. o o m n m <br /> ------ C�f — - — to to x m o w c ia MATERIAL SAMPLE <br /> Sample ID Dale Sludge soil Water Air N° °I _ o m N m E DESCRIPTION CONDITION/ <br /> —_ — — - conts to ] _ a c� COMMENTS <br /> PT lnl N Z <br /> c'�/ 5 �.✓ \ � � v�eppi oA�as <br /> r — - - - - - -- -- -- - — -- - ftJr/Jr,. <br /> -_--- -- - -- - -- --- -- - _ x1 -0 <br /> �P i 6 w - - -- - ----- -_ <br /> c <br /> e or <br /> ;hn <br /> lmqul f�gd ature) Prink N�e Dale p, q y w <br /> —)— — Print d ame_ D��30 <br /> tc .'G <br /> Time J ra _ Z� _f Time ��JU_ <br /> ishe Y( lure} P In d Name flala 7 �ti (] ne } Printed Name Dale <br /> L Q�o Time cb) <br /> n t uished By nature) Pr need Name -- Time <br /> Dale _ neceFi—LM <br /> nalure) Panted Name Date � <br /> Time % Tme_ - _MUST PROVIDE A COPY OF TI I1 C C5TO WITH INVOICE AND RESU1 TS -� <br /> REV 411i93 --'----�-------'�—----� -- --� �--- SHELL OILY CHAIN OF CUSTODY <br />