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U IUb <br /> Fax corAwf Lab Report and COC to Chevron Con O No Chain--of—Cusfo Record <br /> Chevron Facility Number 5221-•5 Chevron Contact (Name) Brett Hunter <br /> Facility Address 5431 West Grantline Rd. , Banta CA (Phone) (510) 842-8695 {_ <br /> Chavron U.S.A. Inc. sj�r-0 S/�3 equo�a <br /> P.O. BOX 5004 Consultant Project Number Laboratory Name <br /> r� <br /> $011 RUrnaTl, CA 94583 C°nsuHant Home Bligine Tech Serizires, Tnr Laboratory Release Number 1714390 <br /> Address_ 985 Timothy Dr. , San Jose, CA 95133 Samples Collected by (Home) AV. Arrrlir <br /> FAX (415)842-9591 <br /> rr Jim Keller <br /> Project Contract (Name) Collection Hate <br /> (Phone)(408) 995-•553 ax Humbar)(408) 293-8773 Signature <br /> Analyses To Be Performed NOTE <br /> po NoT BtL4 <br /> A ,. a o -CB-ZB SAMPLES <br /> E5 <br /> <U p � � O a <br /> Z a $ b 1 a a a o ° n5 <br /> coo a $ <br /> E a9 t b � <br /> +oe �'w <br /> a <br /> -SZ, <br /> m °° E 1. <br /> o" <br /> Re 3 ° oaa. marks <br /> A,o23 <br /> din 1sh (Signature) Organl llon Datap" q Reoely Dy ( gnolur Y Organization Qate/TT`lme � Tum Around Time (Circle Choice) <br /> YtA4i � er � 24 Hre. <br /> .-A (S na re) Orgonizallon pate mm'e Recelved By (Signature) Organization Date/lime 48 Hrs. <br /> S O Qoye <br /> sy (Signature) Organization Dale/Tlme Reaf For Laboratory Dy (Signature) DaterTlme Ae Contracted <br /> � I��t 4a _ 9 -aa' <br />