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Date: *004 <br /> OPage <br /> OF CUSTODY RECORD 1 <br /> SH L OIL COMPANY Serial No: Pal <br /> G <br /> LAB: Kiff Analytical <br /> Analysts Required <br /> Site Address: Si ell Pipeline,Mountain House Pkwy CHECK ONE(1)BOX ONLY crm"1' iuxN axoUNO1M1' <br /> Tracy,CA Gw Monitoring O 4461 24 horns <br /> WIC#: Site Investigation <br /> X 4441 48 hours O <br /> U <br /> Shell Engineer: Jeff Goold snilClassirymisposal O 4442 15 days X (Normer)O — <br /> Consultant Name&Address: Phone: 925.4262600 <br /> b water Classify Disposal O 4443 Other <br /> Fax: 925.426.0106 o O 4452 <br /> Clayton Grp Serviceso Snil/Air Rem.or Sys O&M <br /> 6920 Koll Center Pkwy,Ste 216,Pleasanton CA 94560q <br /> water Rem,at sya.o&M O 4453 <br /> Consultant Contact: Mike Hurd I Craig Pelletier o other O <br /> Comments: <br /> O UST Agency: <br /> o � o <br /> Sampled by: CraigPelletier Q o <br /> Sample Condition/ <br /> Printed Name: Craig Pelletier F x Comments <br /> No.of Material Descri tion <br /> Sam le ID Date Stud a Soil Water Air conts. Groundwater <br /> X 5 X X X <br /> ' MW-1 8/1 004 Groundwater <br /> X X X <br /> MW-2 8/141004 X 5 Groundwater <br /> X 5 X X X <br /> ✓ MW-3 8/11 004 Groundwater <br /> X 5 X X X <br /> MW-4 811 004 Groundwater <br /> X 5 X X X <br /> MW-5 8/10 n04 Groundwater <br /> r MW-6 8n 004 <br /> X 5 X X X <br /> ate: <br /> Received(signature) Printed Name: <br /> Rclin she ( go re) <br /> Printed Name: <br /> Date:A p lime: <br /> Craig Pelletier Time: I d ADate: <br /> Printed Name: <br /> Uate: Received ' ature) 1e; <br /> Printed Name: _ <br /> Relinquish y(signature) Date:41}j/d <br /> Printed Name: Date: Ke ed(signature) y Printed Name: <br /> �I If S Time: <br /> Relinquished By(signature) une: . <br /> Till LABORATORY MUST PROVIDE A COPY OF TtllS C IAIN UST-OP DY TH INVOICE ND RESULTS <br />