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0 • 4"lX l 0 -f 5 t f_iy/_ __�y _!� 0 <br /> 1 <br /> SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Dole. l� 648 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serlal No. page 3 of 3 <br /> Slle Address: <br /> 2575 Country Club Blvd. , Stockton, CA Analysis Required LAB- <br /> W,Ca: _ <br /> 204-7524-3505 CHECK ONE 11p IOX ONLY CT/01 TURN AROUNp TWE <br /> cn <br /> Shell Engineer: Phone No : 510 t- G W Mao%Kodng "`i <br /> _ � 24 hours ❑ <br /> Alex Perez Ifa�7j: 6168 Silolnr.sllgdbn ❑ 4ui <br /> I6 noun El <br /> 675-6122 <br /> Con aullqn! NCq�mg &,�dd ess• o <br /> V'aTne 'tech Sery ces, Inc SolCkwVy/Disporal ❑ "A3 <br /> to d i6days (Narmaq <br /> 1680 Ito ers Ave. San Jose CA 95112 x ryale$ <br /> Consullani Conlach no No.; 408- -- ltr pota' <br /> � clar: lass ius 01h.r <br /> Fran TY►ie Fox3_57357771 q ar o0 als !J 4) C14 Do oithR.rrLorsy: ❑ us3 <br /> LO � <br /> COmmenls: NOTE Narlly Lobar <br /> VS Warr k.rt> ar Sys roan at raulbl.of . <br /> O 4 a m O 1 i l ❑ 115] 21/43 his TAT <br /> x � <br /> Sampled by. kr) V4 9 z ara.r ❑ <br /> v o c- <br /> b ° e Cto y UST AGENCY:o O HPrlrled Name. Q a_ $ <br /> ° a, d aCL <br /> MATERIAL <br /> Sample ID Oala Sludge Sol! Wafer ASAMPLE <br /> No of x ac w CL <br /> �- ° ° '^ a �' o DESCRIPTION CONDITION/ <br /> m '- v ¢ u a v COMMENTS <br /> j9Ls �� 2 nil <br /> ZY6Bcc, p X x <br /> 1 Zgs6 Cc <br /> Z Li c.c n 14 °t — <br /> x x <br /> 9(J P x - <br /> Rallnq h d By afar ) Prinlad Noma, <br /> R, leo {slg lura) Pr fTipd Noma Dala to -P'�P <br /> tnt tHf lime ! � � l �a�G1.S ,-3 <br /> iinq ed (signal ) Printed HomoDale lam- - Recelved(Ognaluro). ame. Da s• <br /> L+S arrJ G Time — I-`- <br /> Time <br /> RallAquished By{ na o) Printed Home, Oale Rocelvad(slona ). Print Name. Do IQ <br /> Tlmofp ZD (\j nme fqoq <br /> OPY RETE+ <br /> aml �lvin <br />' awasaft wa,ba <br />