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'M efi sapeake" MOM09111INWMAIIIIIII <br /> Redwood City, CA 94063 PO Box 2180, Houston,TX 77002 7426 <br /> (650) 364 9600 • FAX (650) 364 9233 CHAIN OF CUSTODY <br /> Consultant's Name —�� ✓��(�BYI � �� �C Page _! of <br /> Address _ —� Site Location 1- _ <br /> Project # Consultant Protect # r Consultant Work Release # <br /> Protect Contact �J I JVD V��1 Phone # C7 7J (P Laboratory Work Release # <br /> EXXON ContactPhone- # <br /> f _ EXXON RAS # L <br /> Sampled by (print) Sampler's Signature <br /> c <br /> Shipment Method ,�� Air Bill # a- <br /> TAT ❑ 24 hr 48 hr ❑ 72 hr a 96 hr Standard (10 day) ANALYSIS REQUIRED <br /> TPH/Gas TPH/ TRPH m��, ! emperalure <br /> Sample Collection Collection Matrix Prsv # of Sequoia's BTEXI Diesel S M `� <br /> Description Date Time Soil/Water/Air Cont Sample # 80151 EPA 5520 Inbound seal Yes No <br /> 8020 8015 Outbound Seal Yes No M <br /> o <br /> Is 737 <br /> mui <br /> 5ZCU <br /> _ t <br /> �5 <br /> co <br /> f o <br /> 0915 -- <br /> -to Zf�S c�oZ ��k <br /> RELINQUISHEP,B FFILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br />