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CQ �UP780Chesa sake Dr x C A a S. . WW <br /> Redwood City, CA 94063 P 0 Box 2180,Houston,TX 77002-7426 �� — V l <br /> (415)364 9600 • FAX(415)364 9233 CHAIN OF CUSTODY k <br /> Consultant's Name 1E 01/'l CP ge of <br /> Address f/ +'�� �- Stte ocation U-QDRAG� C T 641 <br /> Project# Consultant Protect # G� t �� Consultant Work Release # {'z <br /> Protect Contact (�k) Ick �/) 76�l Phone # ; �,� ���--� Laboratory Work Release # <br /> C <br /> EXXON Contact Phone # _o �'f� �i j ��� EXXON RAS # ��l�f`7 U <br /> Sampled by (print) Ct'�r' f Sampler's Signature <br /> Shipment Method Air Bill # ri <br /> TAT ❑ 24 hr ❑ 46 hr ❑ 72 hr ❑ 96 hr Standard (10 day) ANALYSES REQUIRED ci 17 Z <br /> Sample Collection Collection Matrix # of Sequoia's TPH/Gas TPH/ TRPH Temperaturo <br /> Description Date Time Soil/Water/Air Prsv BTEX/ Diesel <br /> P Cont Sample# 8015/ EPA 5520 Inbound Sual Yos No <br /> 8020 8015 Outbound Soal vas No sa <br /> J' o <br /> ET <br /> QI <br /> I'YZVtJ �7' 0 2 0 <br /> �UJ� v3 <br /> T <br /> 4 <br /> vJ 7 r qob 6 if <br /> Rinse <br /> P bre N P, <br /> i <br /> RE INQUIS ED BY/AFFILIATION Dare Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> y V ' <br />