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IS <br /> SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date eR Lt <br /> RETAIL ENVIRONMENTAL ENGINEERING-WEST Serial No Page of <br /> Site Address Analysis Required LA13 G�1'Ut Ac <br /> W109. <br /> q— I l S O� CHECK ONE(1]BOX ONiY C710TURN TURN ARC�ND TIME <br /> OW Monitoringj <br /> Shell Engineer L �6r ho a No ?S Ug L7 44et <br /> f 24 ttoun ❑ <br /> L`�NN t,.►ArL r Stsinvestlgatlon ❑ 4"1 <br /> ax S-(pll <br /> [ ] as ban ❑ <br /> Consultant Name 8 Address Fit N N SOI CInt"Yrl)Wmal 4 42 <br /> I15 dap <br /> � <br /> 0 D L too N a) ansly/ i ai 443 <br /> Consultant Contact L 011ieElhp 1e No -Z1l saWAlr Rem Or Sys <br /> I kk, � � Rax#7 Rb-? w m o�M El use <br /> Go ROTE Nat1Y Lab n <br /> Comments- �} 8 r C4 rj O t A Rem or Sym 2 hpaAatble of <br /> ��-30 Q 9 <br /> Sampled b _ c I r �- Exner U <br /> CO w e Q ti > UST AGENCY [J �2MOI N1 <br /> Printed Name K.� w w W O I o 9 „ -9 ,w <br /> 9 MATERIAL <br /> Sample ID Date Sludge Sod Water Air No of E - SAMPLE <br /> = x E conga a DESCRIPTION CONDITION/ <br /> COMMENTS <br /> lJ l 7S`t �W)Frf r <br /> Hal lied ay(sig rel P Name _ T -- - — �— -- -- ——- — <br /> JateL[ b Rectkved(signature) Printed Name Dal <br /> �{ e <br /> 'BY si Hera) Prin Time C.S TaEte <br /> fr Date _ I nature) / rated a r = ,�_r <br /> L 7/� — Time r J�0L� �.� i�� r YYl [j�) 1� Timle <br /> ulshed /�aignahue) Printed Name Date Reccived(slgnatura) Orinled <br /> Time Time <br /> REV trt/ott <br /> THE LABORATORY MUST PROVIDE A COPY OF THIS CHAIN OF CUSTODY WITH INVOICE AND RESULTS <br /> —-----.-- _ <br /> SHELL OIL COUPANY CHAIN OF CUSTODY <br />