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LAB(LOCATION) 4 Shell Oil Products Chain Of Custody Record <br /> ❑W ENCE I ' PleaaE Ct\eck Appropriate Boz: ' Pf(nt Bill To Name;: INCIDENT#{ENV SERVICE( 1 aSERVICES). IF NGINCIDENTt APWE6 <br /> 0SPL _ Contact <br /> ❑ENV.9ERVICEs ❑NOMA RETAIL ❑SHELL RETAIL <br /> ❑NENCC( 1 ���AUBREY CCOL 241729 300002 GATE Y <br /> O MarnA sSecM p consuLrANr ❑weEs pq # SRP# Z <br /> NEST AMERICA ( 1 <br /> ❑OTMEA( 1 <br /> OSNELL nPFUNE ❑OTHER —� 35664 ' PAGE: D( <br /> muvm+. mOE. sllEeng1E55:Sbnl�OPry suu bM <br /> Conestoga-Rovers B Associates CRAW 7515 NAW DRIVE STOCKTON CA CA T060770017G <br /> ¢£CnhhtAldE101Nm.fmmx.QTata6mM1 RK�ENO: EMY C0.Mfer.lxl G0.0£CIM: <br /> 5800 HOLLIS ST,STE A,EMERYVILLE.Calitgmia 9,U D9 shdtadf(M=. Idcom <br /> neon mne�r n. ,Mswrnal Brenda Carter,CRA,Eme Ills 570428.7347 xalTzsssi o.0e <br /> 77777 <br /> AUBREY COOL b41gH1 Xp"`m o-sN LAB uSE oNLr',, <br /> F,= SHERRY PHILLIPS <br /> 510410-3336 (510)420.9170 ACOOL@craeorld.Dom <br /> TUPNMOIINDT`ME(uLL .DAYS): ❑RESULTS NEEDED <br /> m STMWD(14 MY) Os Dan ❑7 Dan 0z DAYS 0 z Noun ON WEEUFNO REQUESTED ANALYSIS <br /> I]a-RwQo REPORT FORMAT Cl USTAGENCY: - TEMPERATURE ON RECEIPT <br /> SHELL CONTPACT RATE APPLIES m a ? Cv <br /> SPECIAL INSTRUCTIONS OR NOTES: ORpm u m m z <br /> STATE MM1R5EMEM � <br /> PATE APWES S <br /> o <br /> [3 no NOT NEEDED a at <br /> 12 NECJFT VERIFICATION REQUEE710 orbu CeC m a m m m m n _ u u <br /> d W a c m m uC F m a <br /> SAMPLING PIR.4RlATAE <br /> use 0< O „ rn u „ - ry U <br /> aOF 9m aa c`o <br /> Container PID Readings aField Sample IdeOATU TIME a. <br /> D. u - or"Derain,Nates <br /> M1 <br /> „qMy!.. 17 MO. ITCAl M301 NONE OPfdi F- F H- I- m m m m O Il £N No W f D. U <br /> 0 - \ Ly& lilt%o SO x x x <br /> a o -o1U Yt, ofCb <br /> lam— 5 coq g,b \ <br /> �*O sb c <br /> o X x X <br /> ELAS— L — l S 50 <br /> AS 16 - Za s <br /> Pa.. cW(sa9vM Nexnea ( D.®. rvre. <br /> Rol Free..) ,r�F�/ rNm W @P�rrl ore: rive: <br /> IF� 11107 <br /> rrairyarebq lsgear•1 v.ma.race+.. Dse: ixe: <br /> JL <br /> 1v:1S- <br /> DvzoNa.+sm <br />