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SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date <br /> RETAIL ENVIRONMENTAL ENGINEERING-WEST Serial No _— Page k of <br /> Site Ad ress� L �c � Analysis Required IAB <br /> t 5`rLet�r t jj <br /> wi�i# CHECK ONE{ti Bdx ONLY CT,DT TURN AROUND TIME <br /> 2 4 s2kk` i wc} G W fAonAwing I��__allll 41$1 <br /> � � 24 1104111111 I <br /> No -4u��wShell Englnee <br /> 49 hour, ❑ <br /> I' \k- �,,, �1W L'T Fax# 4 1- `� Sell ClasaRy1D*osai ❑ 4442 <br /> Consultant Na 8 Address . _ <br /> f r ti. t<, N _ is day: NNormN) <br /> rpoLl a,sNYlDleposat r� 1443 Other ❑ns taM No Z—1k.1 o m O&MSoIVAr Ram w Sys } M52 <br /> tu, NNOTE Notilr Lab as 1: m m °� Water Ram or Sys soon as posabla a <br /> COmmentS ��� S o O 6 M 403 21118 hs TAT <br /> ra other L I <br /> 72:t a yf b = m — - — <br /> A to to o Y F <br /> Sampled by N UST AGENCY S t <br /> 0 0 _ <br /> k a s <br /> 00.- 00 yr m ° N SAMPLE - <br /> Printed Name y C ' _ — w t�i1 X m o MATERIAL CONDITION/ <br /> No o} x 2 w ro a E y c m DESCRIPTION COMMENTS <br /> Sample ID tate Sludge Sol Water Air costs m j H 8 a _ — _- - ---- — ---- <br /> Rewved e 4 <br /> to E �) Teta L 1 ' �pl !l�( ( ' l ( �( 1 � 1�� 1_ <br /> Time <br /> Ralhpuishad By re) Printed Name Date Received(signadae) Printed Name <br /> Time -- <br /> Relinqu[shed By re) Printed Name Date Received(siprtatwe) Printed Name Date <br /> T _— <br /> Time ima <br /> - THE LABORATORY MIJP PROVIDE A COPY iF THIS CHAiN OF CUSTODY WITH INVOICE AND RESULTS <br /> SHELL OIL COMPANY CHAIN OF CUSTODY <br /> REV 417,97 <br /> 49. <br /> i <br />