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Ana y41rCJr '♦ <br /> sen ci�esapeoi,o Ur ANV <br /> EXXON CO , U S A <br /> Redwood Cay Ca 94063 P o Box 2180 Houston,TX 77002 7428 <br /> (650) 361 9600 FAX (650) 364 9233 CHAIN OF CUSTODY <br /> Consultant's Name Delta / Blaine Tech Services, Inc. Page f <br /> Address 3164 Cold Camp Drive, Suite 200, Rancho Cordova, 95670 Site Location 2705 Country Club, Stoc ton <br /> Project 9 Consultant Project # Consultant Work Release # <br /> Piolect Contact James Brownell Phone # (916) 638-2765 Laboratory Work Release it <br /> `c <br /> EXXON Contact Darin Rouse Phone # (925) 246-8768 EXXON RAS # 7-3708 U <br /> Sampled by (print) IMZIuL S.� aA- Sampler's Signature <br /> _ C <br /> Shipment Method Air Bill # <br /> TAT 1� 2-1 lir X11 -18 lar a 72 lar 0 96 hr Eir'Standard (10 day) ANALYSIS REQUIRED <br /> TPH/Gas TPH/ TRPH <br /> MTB); Temperature <br /> S.u4tlile Collection Collection Matrix PfSV # 01 Sequoia's BTEX/ Diesel S M (B020 <br /> Dt scnplian Date Time Sail/Water/Air Cont Sample # 8015/ EPA 5520 utbo d seal Yes No <br /> O <br /> 8020 8015 umound Seal Yes Na <br /> 0 <br /> Cn <br /> ✓ __ � - 6 1�zS d Ll <br /> -_W_- <br /> RELINOWSHE BY/ FILIAT N Date Time ACCEPTED/AFFI,LIATION Date Time Addiftonal Comments <br /> BTS <br /> 'qN`79 <br /> cG <br />