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k iety, <br /> lytical <br /> I eake 6��CA 94063 P O Box 2180,Maus X 77002-7426 <br /> f <br /> (650)364 9600 FAX (650)364-9233 CHAIN OF CUSTODY <br /> Consultant's Name Delta Environmental / Blaine Tech Services, Inc Page Z- of T-- <br /> Address 3194 Gold Camp Dr, Suite 200, Rancho Cordova, CA Site Location <br /> 1605 S E1 Dorado,Stockt n <br /> Project # D7&-Az Consultant Project # Consultant Work Release # 19908582 <br /> Project Contact Jim Brownell Phone # Laboratory Work Release # <br /> gl6 638-2765 <br /> EXXON Contact Darin Rouse Phone # (925)246-8768 EXXON RAS # <br /> 7-0137 v <br /> Sampled by (print) E ILL, Sampler's Signature _ ean;Z— <br /> Shipment Method Air Bill # CL <br /> TAT ❑ 24 hr Q 48 hr Q 72 hr Q 96 hr Q Standard (10 day) ANALYSIS REQUIRED <br /> TPH/Gas TPH/ TRPH MTBE Temperature <br /> Sample Collection Collection Matrix PrSV # of Sequoia's BTEX/ Diesel S M (8020) <br /> Description Date Time SoillWater/Air Cont Sample# 8015/ EPA 5520 inbound Seal Yes No <br /> $020 $015 Outbound Seal Yes No <br /> 0 <br /> -j0 47 X Cr <br /> 0 <br /> } <br /> ca- <br /> 0 <br /> Cr <br /> m <br /> L <br /> RELINQUISHED BY/AFFILIATION Date Time AC51EPTED/AFFILIATION Date Time Additional Comments <br /> .� _ � BTS <br />