Laserfiche WebLink
SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Dale <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No Page of <br /> 5 to Address Analysis Required LAB `CX u CI A- <br /> WIC#. CHECK ONE II)BOX ONLY Cl/DT TURN AnOUND TIME <br /> Zc� <br /> _ p W Mpnlorrnp ❑ 4481 <br /> Shell Engineer Ph ole-7 <br /> 40-4-15 +-,��'� 24 hot-, ❑ <br /> I l w 10 iSRslmntlpetlon tj 1441 <br /> R_ I v 1" Pax ->-fat i r sol cluslitrov"I ❑ 4442 /a np�r• ❑ <br /> Consultant Name&Address,IFFY-, goST <br /> i-O /�1 o wi�r 1 <br /> CSC PIVW LIS `its y �',j L,�A '1 SIG „ co ChwoOVIDIsposel LJ 4443 Other <br /> Ll <br /> consultant contact �/,e lC j,7&rc t, e,1417L h1XL -*6--* <br /> 9N )e2-xt 4(3 .- sp�Alr nem or Sys <br /> m <br /> l?trv! Al,�! R Iu, � o`M �4�1'S2a3 rn etj NOTE Notly lab as <br /> wwor Float or Sys <br /> Comments. Q - G1 C as ohm ❑ usa 2u48tirioiAted <br /> �f <br /> Othel <br /> Sampled y• J 0 0 CO N C m UST AGENCY-! rX a �R12t 0 _ <br /> Printed Name' �ACL _ _ w a. 0_ a <br /> MATERIALSAMPLE <br /> No of x x E a CONDITION/ <br /> Sample ID Date Sludge Sod Water Air c E m E DESCRIPTION COMMENTS <br /> WrilsRel z u109413y(slgr t re) Print NaDaleDale[ zl '�l Received(signature) Printed Name Date <br /> Wc— t�C G-� � � F-�N�y l t" lime /Z-50 _f _ time <br /> RelinquishedBy{signature) Printed Name pate Received{signature) Printed Name Date <br /> _ Time _ Trme <br /> Relinquished By(signature) Printed Name _pate Received Islgnalur ) — Printed `ame pale <br /> Time __ iL��i,1 1_�__ fll(r tcl Trme <br /> THE LABORATORY IdUST PFiOVJUE A COPY OF THIS CHAIN�F CUSTODY WITH INVOICE AND RESULTS <br /> •IEV Aiug:; — SHELIOILCOMPANYCHAINOV CUSTODY <br />