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i <br /> 7.. <br /> SHEL OIL COMPANY CHAIN OF CUSTODY RECORD Date: -71 T <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serlal NO:..,970710?,;.c► Page -L-01,L <br /> Silo Address: <br />�(/ 2575 Count Club Blvd. , Stockton, CA Analysis Required LAB: ��� <br /> ICO: 204-7524-3505 CHECK ONE(1)SOX ONLY CT/GT TURK AROUHU TIME <br /> G W Monrorina ❑ 4461 24 hour <br /> Shetl Engineer: Phone No.: 510 ❑ <br /> -- - <br /> Alex Perez IF ViT 168 SRO Inradlgdbn ❑ 4t41 AS noun ❑ <br /> CvVlc}nt N�m�&5}1ddpw. Inc. CIO Clauffy/Dlspousf ❑ "42 uany� ❑{Hoemaq <br /> a ne ec ery ces. <br /> 1680 Rogers Ave. San Jose CA 95112 W cam. /pfs sa) ❑ <br /> Consultant Contact: Phone No.; 408- = ti olhsr ❑ <br /> Fran Thie 573-0555 N N 00 Cd OaµROM oiiys. ❑ 4452 <br /> Fax t 573-7771 n m a to NOTE. NOSIfyLob as <br /> D Wolof ROM ors soon as RosJbfe of / <br /> CommBnis: v co O i M C] �� 24/48 hn IAT l <br /> v <br /> _ z Met <br /> I <br /> Sampled by: � <br /> ca 00a 0 CL o UST AGENCY: <br /> rinled Name: `� Gn.9re d W 0 r- [0 .0 � ° C � o SAMPLE <br /> No.of x x w . 0 A MATERIAL CONDITION/ <br /> Sample ID Gale Sludgy 5011 Walar Air coni: r ; Q1 u a v a V DESCRIPTION COMMENTS <br /> _� �� w 3 x k <br /> llnqulshod notut NinleedName. Dale Race lvv sl u Pr pled Name• Daia•� <br /> 1.,.., Gl?aQ� me L- 11mg,Z01 SE: <br /> allue). PT1nty Name: Dale zLL1 b Rec d(signa e). PTlnied Name: Dole, <br /> P�-W F Time Time <br /> +a By(signature). PTinled Name: Dais Recalvad (slgnaiura) Priniod Name: Dale o q-7 <br /> Timo• An Tlmo ►-7 <br /> h.�p Ora M Woo/ <br />