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` 0 = M M MkO� NII.S.A M <br /> u y+c <br /> Chesapeake Dr <br /> Redwood City CA 94063 P a Box 2180, Houston,TX 77002 7426 <br /> (650) 364 9600 • FAX (650) 364 9233 CHAIN OF CUSTODY d 6 -3 <br /> Consultant's Name( ��� � Page <br /> —V of <br /> Address <br /> f Site Location <br /> Protect # Consultant Project # LL <br /> _ 1 Consultant Work Release #_C��� <br /> Project Contact / Phone # Z! Laboratory Work Release # <br /> EXXON Contact (� Phone # j"� EXXON RAS #� 37 U <br /> Sampled by (print) Sampler's Signature Y <br /> Shipment Method _ — <br /> P (� Air 13111 # a_ <br /> TAT E 124 hr U 48 hr Li 72 hr U 96 hr ' tandard (10 day) ANALYSIS REQUIRED <br /> TPH/Gas TPH/ TRPH 1,h1 4Temperature <br /> Sample Collection Callection Matrix prsv # of Sequoia's BTEX/ Diesel S M �,1 — <br /> Description Date Time Soil/Water/Air Cant Sample # 80151 EPA 5520 Inbound Seal Yes No <br /> 8020 8015utbound Seas Yes No c3 <br /> n <br /> 0 <br /> Crl - <br /> - l <br /> i i — <br /> T ;001 ER GUSTO YSEALS I iTACT0 NOTINT CTC, <br /> ODLERTE PERATU a t'? <br /> RELINQUISHE /AFFILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br />