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Fax c of Lab Report and COC to Chevron Cooct. Cl No <br /> t Chain—of d­dCusf0 —Record <br /> ' Chapman F 9-191.8 <br /> aemtr Number <br /> Chevron Contact (Nome) BreCt Hunter , <br /> Facility Addro•e- 45 Harriing�ylP SCochron. CA (Phone) <br /> Chevron U.S.A. inc. g6D`/Z - _ (510) 8k2--8b95 <br /> P.0 BOX 5004Consultant Protect Humber '+� Sequoia <br /> Blaine Tech Services Inc. Laboratory Namo <br /> Son Ramon, CA 9-4583 Consultant Name <br /> 985 Timothy llr. , San .TOSI , (;/� {}�1_j,.j Laboratory R•I.oe• Number 2642370 <br /> FAX (415)$42--9591 Address P y ( )�_ <br /> Snm las Collected b Namo �'V P( <br /> Project Contact (Name) Jim Keller <br /> Celleollon Rata <br /> (PhonoYL — ,(Fax Ftumhar).�iQF3�,����— Signature <br /> �Lj_�_• <br /> Analgees To Be Perform d 4s) <br /> f3 A° u DO NOT BILL <br /> z <br /> if a FOR TB-LB <br /> 00 <br /> M rn <br /> a <br /> n 4 g r <br /> �{n o <br /> Vi 9 x W)c <br /> Remarks <br /> Ze- -- W 150 �C <br /> ?< g <br /> FI•lfn u ed By (Slgnotur) Organlratlon D te/'n Reoelyod By (Signature) Organization Date me <br /> /� Turn Around Ttms (Circle Chofo•) <br /> ti /d w 24 "ra. <br /> tlnqufshed By (Signature) organization Dat• me R sired Dy gnatur•) Organize tla a 48 Nn <br /> shed By (SI- ature) orgonizatlon Date me Reclevd For Laboratory/tg lgnalure)— Dote/I]rno t� Dago <br /> fI Jts Canlrnoted <br /> �� _ <br />