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qV- <br /> ELL OIL COMPANY CHAIN OF CUSTODY RECORD Date: <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Sorral No- ____�Z7P 020 -SPago +101 <br /> Silo Address: _ <br /> 7910 Lower Sacramento Rd. , Stockton, A AnalyS Required LAE: <br /> lylC#: <br /> 204-7524-0808 CHICK ONE Il)SOX ONLY CVDT TURN MOUND 11Mi <br /> I <br /> Shell Engineer-. �1 CW. monlomo ❑ asst '24 hours ❑ <br /> g Phone No,• (510) <br /> Alex Perez 675 6.168 S sl.tarallporbn <br /> Fax li 675-6172 - ❑ T As hours ❑ <br /> CIslai e Tec tta & AOdrosvices, L; Sol Ckisdyfl)Upoeal ❑ aux <br /> %Laine echh Serv�.ces, ince ,� Taaays ®(rrermal) <br /> 1680 Rogers Ave. , San Jose, CA 95112 woT.r <br /> Consultant Contact: t x crorr /Dlrporal ❑ � <br /> Phone No • ( r08) v m W other ❑ <br /> Iran Thie 573-0555SoRlAtrRem orSys, <br /> 9:Fax • -7771 o m .0 O&M <br /> COmmonlS: ❑ asst <br /> wC M NOTE HotUr labor <br /> ,� wor.rRerm or Sys soon ai F6611b3e at <br /> t7 .0 `�.' O j6M ❑ a!S] a1/1S hre.TAT <br /> Sampled by: N r o z arr,.r ❑ <br /> �� ca Co a o` N o d) LIST'IAGENCY: <br /> Printed Name: 4 Q at N <br /> `� Vy ° .0 <br /> PlNo,or .o o MATERIAL <br /> SAMPLE <br /> x o CONDITION/Same ID Dolo Sludge Soil Water Alr I- o DESCRIPTION <br /> conls > <br /> U COMMENTS <br /> �jlqw3� -1 <br /> deere� b <br /> laza <br /> r <br /> `Relinquished By(signatura), PNnlad Nam -� flat 71 R od(slgnaluro), Prinlod Noma. Dale: <br /> �l Time �f/ __ . <br /> uishod lura): Printed Name. Dale ocolvod(signature), P1lnlod Noma: Da o• <br /> 11mo% Tlme <br /> qui:hod By(slgr alure) Priniod Namo Dalo lRocolvedlijnoluro) Prinle amo: Dale -ZS-q7 36 <br /> Tlm4 ,Q Lep �'- d Tlmol <br />