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I <br /> SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date <br /> RETAIL ENVIRONMENTAL ENGINEERING-WEST Serial No Page 1 of <br /> Ste ddress - -- - <br /> 1 1J. ; A - Analysts Required 1A6 i�l 4- <br /> WIG# - — - — -- - - -- -- - - <br /> CHECK ONE 11!BOX ONLY CTIOT TURN AROUND TIME <br /> G W Monitoring 4461 <br /> Shell Engineer Pho No(.o 7,i-- z4 Hours l ] <br /> ASae Investlgalion t I 4441 <br /> �" {,1�• Fax ]i a Ll �- 4442 <br /> Sod Classlty/Disposal 48 hours l 1 <br /> Consultant Name& Address Arfi.iL� o <br /> I I <br /> [ f _�77rr NO W�tor 15days (Nartt31) <br /> A-, V t 6x- ��J4�� 130 Classdy0sposal I I 4443 <br /> Consultant Contact hgna No)( -,��j" o w Olhar I 1 <br /> A SorUAir Rom or Sys <br /> �y '?r� - r✓`t cN N m o a M I 4452 <br /> cli to Cd NOTE NoldyLabas <br /> Comments V' 0 Q u) Water Aern or Sys soon as possible of <br /> �y V 0 d 0 3 M hl 4453 2448 his TAT <br /> c_n !LI m <br /> a <br /> I t� � N m Olher <br /> Sampled byU <br /> e - - - -- - <br /> - o a "- UST AGENCY.-:W ibk4%� rJ <br /> Printed Name�,'�tr PAM40 a- a- w O cc U) `4) o <br /> — -- - - --- - - - - - - w w x a` 19 En <br /> V) m I6 MATERIAL SAMPLE <br /> Sample ID Date Sludge Soil Water Air No of a o o N E a CONDITION/ <br /> tu E (n C m E DESCRIPTION <br /> conts F- t— m > t- U Q U a. COMMENTS <br /> SWOOr <br /> e ngwshed By(sl fur Print e t l y Date l �ieci(si Halo Printed Name Date Y <br /> `i Time M, y� -- C ��C flit ��h1� a,J _ Time �. <br /> A qui hed y signature) Printed Name Date �r ved sl n tore � _L p t me �.�y <br /> C.L C M#N (�/yT l�jl Date <br /> y1 � � c "'^� Time r. _ _ Time <br /> Relinquished try(sr tura) Printed Name Date Received(signature) Printed Name ---- - Date - <br /> __ Time _ Tlme <br /> THE LABORATORY MUST PROVIDE A COPY OF THIS CHAIN OF CUSTODY WITH INVOICE AND RESULTS <br /> REV 4/1193 - _ S1iEL L Gil COMPANY CHAIN OF CUSTODY <br />