Laserfiche WebLink
EXXON COMPANY, U.S.A. <br /> P O Box 4415,Houston TX 77210-4415 <br /> 4 a P a w i E a ® CHAIN OF CUSTODY <br /> THE ASSNR,NCE Of Oli.liffY <br /> _- Consultant Name _�I G clot', i c 614 e-� f CG L+j c, r -14 .+1 <br /> Novato, CA Address 23_-so_ D��c. D�-�_S� /G�u /2a dre.4c rE;=Zn/c- r L4 <br /> 11 Digital Drive,94949 Prosect Contact_j,i c2c<<►j 3�� r Proles <br /> (415)883-6100 _ Phone �� /6) 63 ,;� Fax x Cq(E)6 3 3-, 3"3 � <br /> ❑ frvine,CA Consultant Work Release it <br /> Alton Business Parc <br /> 30 Hughes St ,Suite 206,92718 Exxon Contact AA G l 4 [ G' / / Phone 0 CS/0 Y,6 - S 7 7E, <br /> (714)380-9559 site RAS x `7- 3-7 o <br /> Site LacaGon „ . .. <br /> - L_7 v,�_ rL��-�z�+r, C � /� ` <br /> Laboratory Work Release 9 <br /> pied by(please pnnt) SOIL. WATER <br /> C,v. "Qk-- SC re�-}c rt <br /> Sampler Signature Date Sampled <br /> Sample Collection x of Remarks <br /> Descnption DaWrime Matnx Pmv Contw iau o w m g o w ai <br /> M w 3 6 w ff— <br /> KA U-y 110'3c y x <br /> G.,-- ,- /o} y 't d•7 <br /> Wl 1'." -46Cooler <br /> No Relinquished by/Affiliation Accepted by/Affiliation Date Time <br /> Cooler seal <br /> Intact <br /> ❑ Yes <br /> ❑ No „L <br /> Tumaround Time V 14 e c'0-� <br /> (circle choice) Z Z0 <br /> 24 hr <br /> 48 hr <br /> 72 hr96 hr <br /> C <br /> (standard) <br /> Shipment Method Additional Comments <br /> Coo ,-. Q I <br /> Shipment Date <br /> e'- o-SZ <br /> Dtstnbution White-Original Yellow-Exxon Pink-Lab Goldenrod-Consultant Field Stall <br />