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CHAIN OF CUSTODY No. 100194 [Page-of <br /> CONSULTANT'S NAME „� � CONSULTANT'S ADDRESS <br /> Afe— <br /> BP SITE NUMBER BP SITE I FACILITY ADDRESS CONSULTANT PROJECT NUMBER <br /> SOD .J L <br /> CONSULTANT PROJECT MANGER PHONE NUMBER FAX NUMBER CONSULTANT CONTRACT NUMBER <br /> BP CONTACT BP ADDRESS PHONE NUMBER FAX NO. <br /> LAB CONTACT LABORATORY ADDRESS PHONE NUMBER FAX NO. <br /> BP CONTACT REQUESTING RUSH TAT(Print BP Contact Name) RUSH REQUESTED OF(Print Consultant Contact Name) DATETIME SHIPMENT DATE SHIPMENT METHOD <br /> TAT: F-124 Hours r748 Hours n 72 Hours Standard 7 or 14 Days ANALYSIS REQUIRED AiRBILL NUMBER <br /> CONTAINERS PRESERVATIVE <br /> SAMPLE DESCRIPTION COLLECTION COLLECTION MATRIX <br /> GATE TIME SOIL/WATERNO TYPE LAB b v� COMMENTS <br /> (VOL) SAMPLE# ICL <br /> r ,sc x <br /> /3 S <br /> d ZC7 `7 <br /> ir© /S <br /> SAMPLED BY(Please Print Name) SAMPLED BY(Signature) ADDITIONAL COMMENTS <br /> RELINQUISHED BY/AFFILIATION DATE TIME ACCEPTED BY/AFFILIATION DATE TIME <br /> (Print Name I Signature) (Print Name I Signature? <br /> •L� /V�f /ao <br /> CLV-16722-A(2197) <br /> PKG150 DISTRIBUTION: WHITE.ORIGINAL(WITH DATA) YELLOW-BP PINK-LAB BLUE-CONSULTANT FIELD STAFF <br />