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r <br /> SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date: 5 1 lye, <br /> RETAIL ENVIRONMENTAL. ENGINEERING -WEST Serial No.: Pag$ of <br /> Site Addr/es•s: Analysis Required LAB: ✓a.G� <br /> WIC#: / CHECK ONE{l)BOX ONLY CT/DT TURN AROUND TIME <br /> -7 z�t— 3 v 7 G.W.Monkaing ❑ 4del <br /> Shelf Engineer: PhDpe f O. 24houra ❑ <br /> Ske Investigation 4441 <br /> r17, Yt Fax #: 1 617 L Sod Clasekly/DiapoaW ❑ 4442 48 hours El <br /> Consultant Name 8 Address; �-y��� cs� ,,«, 15ae� .Q�-{Narmalt <br /> r n Water <br /> 1 l��f / ClasallyfOlepoaak ❑ 4449 ❑ <br /> ConsltantrContact: I Phone No.: 9(t n SolVAlr Rem.or Sys. <br /> /� 7eZ-2111 FA 14 m O&M El 4452 <br /> J 14 tiK41f�,r r t ,-%4-n e' Fax M 7 r _7V 5o w N co «S NOTE:Moldy Lab as <br /> 0 0 U) Wajer Rem or sya. soon as possible of <br /> Comments: . o 0. o O O&M El4459 24/48 hie-TAT. <br /> 13 '0- O O rn W co <br /> 0 mr Other ❑ <br /> Ln tn 04 <br /> Sam led la o o Qco <br /> o c > UST AGENCY: �D :rt <br /> t� m <br /> Printed Name: 1�� �� tnu _ w _ �°� ° N MATERIAL SAMPLE <br /> No.at z a E .0 c CI DESCRIPTION CONDITION/ <br /> Sample ID Date Sludge Soil Water Air costs. j 'a [i. COMMENTS <br /> S101 Z_ <br /> - j <br /> li qul9 y{signature) PMAT <br /> i a Date /B ecel d alur ): Name:_ <br /> A b6 J !�� TIme- 1 (f%I c ?.tib y 6w E 1 Time: <br /> elin uislti y sl a}: PrI I Name: Date J� ived{signal r P(lnle4 Name: pate: <br /> Time: /3 ZD Time: I <br /> R n uished to signature): Printed Name: tale: iKecelvV(signatur Printed am Dates 5 <br /> Time W, I f Time: <br /> THE LABORATORY MUST PROVIDE A COPY 09 TFOS CHAIN -C STODY WITH INVOICE AND RESULTS I <br /> EV.411193 <br /> SHELL OIL COMPANY CHAIN OF CUSTODY <br />