Laserfiche WebLink
SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Dale <br /> RETAIL ENVIRONMENTAL ENGINEERING -WEST Serial No Page ` of <br /> site Address - } I Analysis Required IABL Ac <br /> w1C# CHECK ONE($)SOX ONLY CT1DT TURN AROUND TIME <br /> G W Monitoring 4461 <br /> StTell Engineer -- - -- - — - _ Phana No <br /> (_�T--[>A Sitelnvestgali°n <br /> 4441 244 hours <br /> 8 h°trstM �t#1al —ucl SoEI ClaSsdY Disposal 4442 <br /> [ 1l <br /> onsultant Name 8 Address L.t� <br /> Co Wal©r 15 days Normal) <br /> & U t"1ii Lrii o-% j 1 L ]�� _kqs v LL (��'4 5 X Classify101sp°sal L ) 4443 01ner f 1 <br /> Consultant Contact Phone Na '-Z�` Soil <br /> a�r Rem or Sys I ! 4452 <br /> A <br /> ���� m <br /> A UL C \? �� � _ Fax# 'l tom."��� � m °d NOTE Notify Lab as <br /> _ C14Ur 0 °D L0 Water Rem or Sys soon as possible of <br /> CammentS — CL'7l ?� ��f�`r- a O O&M 4453 24148 his TAT <br /> 0 0 EQ co <br /> M M p y Z 0 Olh°r I <br /> Sampled by J Y � - -- Co ME a N > UST AGENCY, �C�h31.� <br /> 4'N eZ) <br /> 00 co P' g `n o m - — <br /> Printed Name j� c' � �N — w w Lu o c o c SAMPLE <br /> -- _ _ a ,� ro MATERIAL CONDITION/ <br /> No of S z w b In E c m E DESCRIP TION <br /> Sample ID Date Sludge Sod Water Air conts a. ( m j tj Q a COMMENTS <br /> 4 IM L- <br /> I <br /> A uish d By(SI ur Prmt Name Dated i� Recel sign lure} ,' Prd Name /� ` Date J� <br /> Time <br /> Time i <br /> tg <br /> Reil e y sl na r Pn Name / D_ate 4 l% i (s g ure) ' f Pn N nR I Date <br /> l <br /> Time /� �� U L(,LL 7! I`L 961 <br /> Time <br /> Relinquished (slgnatur I Panted Name Date Received tsignature) Printed Name Date <br /> Time Time <br /> W THE LABORATORY MUST PROVIDE A COPY OF THIS CHAIN OF CUSTODY WITH INVOICE AND RESULTS <br /> REQ 411,93 T — -T7 - SIiFLLOIL COMPANY CHAIN OFCUSIODY <br />