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LL OIL COMPANY q1tHAIN OF CUSTODY RECORD Dale: v -V <br /> RETAIL. ENVIRONMENTAL.ENGINEERING - WEST Serial No: Page I of 'z <br /> ISHe Address: , <br /> 5 -octvtrr uwb (vr� STS Analysts Required LAB: o. <br /> WIC#: 204— 75;2 y ?t/ J(0 C CHECK ONE(1)SOX ON1Y CCF/Dy 11 TURNAROUND TIME <br /> Shell E gI ser: ` Phone No.: 510 G w Monvorma ❑ "si 24 ham ❑ <br /> /► �"�, �P/V�°Z <br /> Fd" �-50X7 pn s>f.Inr.dlpdbn IIIc <br /> IR hour r] <br /> Consultant Name&Address: F , s•ncbnuy/akposal ❑ 1112 16 days (911101 o <br /> Cambria P.O. Box 259 Sonoma CA 95476 `D WOW <br /> T Cloally/Disposal `� 4"1 <br /> Consultant Contact. Ph# 707-935-4854 0 ah.r ❑ <br /> to 6aRJAh R•m.ai Sys <br /> Joe Neel <br /> Fax 935-6649 in DAM ❑ //r4 <br /> � � Q Q � NOTE, HalYy tab m <br /> p, .— Wale!Rem.as syr Loon ON frig le of <br /> Comments: .� ,o '� y�u� O a m ❑ u6� 2///6 his IAT <br /> CIO <br /> a C3 <br /> � Z Olh•� ❑ <br /> Sampled by: �p. � a C <br /> 0 a o a 0 o UST AGENCY: <br /> GAIN <br /> Printed Name: JOB IV','( a M 2 g a 'i 0 r a' SAMPLE <br /> �!.! i3 MATERIAL <br /> No of s s � 6 U o 0 aai a DESCRIPTION CONDITION/ <br /> Sample ID Data Sludge soil Watar All cont:. N N as y °l U U i U COMMENTS <br /> Mw- la -4-53 air X �� <br /> w- Ix -d6 z a 17 <br /> Akw -I; - 31 <br /> UU) - I�- `isS <br /> w -�a Sa,S <br /> Rell y aria e): Pr n Name. Date,l 7 a gnalure • Ohl d Name, Data. ti <br /> In � [rY„s <br /> R bynahro): Prlri Name: Date: Rocely (d ra)� _ Prin1 ama:----------Dole, <br /> w.yJ � <br /> TirT1a <br /> fl y Printed-HamqL—_x_ Date: Received(slgnalure • ✓ Printed Name. Data: p <br /> nm.; rlrTTe: sl� <br /> -THE JABQRAM&Y MUST PROVIDE A COPY OF THIS CHAIN-OF-CUSIQ DY W1111 INVOICEAHU RESUL15 <br /> mid dan 01cumillft <br />