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s SHELL OIL COMPANY CHAIN OF CUSTODY RECORD <br /> Da#e <br /> RETAIL ENVIRONM TA NEFRING - WEST Serial No ' <br /> Page of <br /> Site Address Analysts Required LAB <br /> CHECK ONE it)Box ONLY C 11D l' TURN ARouND r11Nf <br /> a w Monkoling ❑ 4191 <br /> Shell Engineer ------- ------- Phone No 5IP --- �, 24 hours ❑ <br /> I v 74 -//c--,9 SIB <br /> 7 �\ She Invesl4atlon 441 <br /> Y�t1 v,7 <br /> kirk Fax #�� --�L..d� ~I � 49 houa ElSol cla6ally0sposai ❑ 4442 <br /> Consultant Name & Address fa Lv,y fo T r. N ��r�- <br /> 1I /f} O Walar IS days er (Narmal) <br /> e ��[� L .� l�C—(�L' 1���' � �� X clasatlylAlapoaal ❑ 4447 r , <br /> Consultant Zon#a�f -2-2 f Phone No )—i-(11 r -_- o � SulvAlr nem or Sys ` Other 1-1 <br /> Fax#,ti , z [U m 1� O&M L,) 4452 <br /> ' -7L'G'7.17 3e N '4 co cd NOTE Nally Lab as <br /> — (� iJ Wafer Ram or Sys <br /> Comments Q y anon as possible of <br /> N +- O&M ❑ 4451 241481ua TAT <br /> 0 0 ren W co E� <br /> Sam fed b �— LL to to c\1 <br /> ;� x m Diner — <br /> P Y ��. co co a m $ C 5- UST AGENCY C.n <br /> Printed Name moi- �� - - — as n- w O a m °- w -- <br /> ---- - / <br /> MATERIAL <br /> SAMPLE <br /> Sample I Date Sludge Sa11 Water Air No of z s n m m cL CONDITION/ <br /> conk m 3 D><SCRIPTION COMMENTS <br /> - 1 - - - - -- - — - — - -- J r �+ <br /> Relln uldae4-13 r Prknt Name /J Dale G liecolved(slgnaturo) Printed Name Dale <br /> �[C�( I L�AQ� Time 14-11 _ ___ _ _ Time --_ <br /> R u s y(signature) Prinled Name! Dale _ flecerved{slpnalurel Printed Name Dale <br /> _ Tillie __ __ _ _ _ _ _ Time <br /> ehnqul.h.d By(signalure) Printed Name Dale Recei d(signature — Punted Name Date 7 <br /> _ f <br /> Tune <br /> THE LABOHATDRY MUST PROVIDE A COPY OF 7}I CIIAIt CUSTODY WITH INVOICE AND RESULTS <br /> REV 4/1/97 Slit—it 08 fLOMPANY CIIAIN OF f I1STr1t1Y <br />