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ANIL <br /> EX N COMPANY, USA. CHAIN OF CUSTODY RECORD NO Page ofy <br /> ANALYSIS REQUEST OTHER <br /> Exxon Engineer Darin Rouse Phone 925 246-8768 CHECK APPROPRIATE BOX <br /> Consultant Co Name ETIC Contact John Ortega 0 ° <br /> Address 144 Mayhew Way Phone 925 977-7914 ° r <br /> CA 94596 Fax (925) 977-7915 `� ° ° ° ° a. ° <br /> Walnut Creek, $ N o a ° y J <br /> Cl � ¢c m J a 0 r <br /> tA ❑ ❑ <br /> RAS # 7-3942 Facility/State ID # (TN Only) > ° ° m o N <br /> AFE # (Terminal Only) Consultant Project # 26 <br /> M 0a <br /> Location 4444 N Pershing Ave (City) Stockton (State) CA rn dto 0) p <br /> EE ❑ C 8 M ❑ SDT z 3 - � ° ° ° <br /> ❑ r7 4 <br /> a , o o 0 a <br /> Consultant Work Release # 19909830 BTS# dOOZZ-1 -J1c J cc YJ m ° $ ❑ m co o r ° ❑ <br /> Sampled By Blaine Tech Services, Inc 1 Print Name G G• Ih ¢ w r > a �' o - w <br /> `� ¢ _ m a a a15 <br /> SAMPLE I D DATE TIME COMP GRAB MATRIX OTHER PRESERVATIVE O °O a w z m aii O q H <br /> H10 SOIL AIR Z m a O I, 7 0 a M t- N <br /> 340 <br /> CA <br /> ew—I 1+y�z�� <br /> )tWrz IA 1 <br /> 44-tivtr8Mw- tuZb <br /> UVM41w- Z lu1S <br /> TAT SPECIAL DETECTION LIMITS(Specify) REMARKS <br /> 24 HR 72 HR EXXON UST <br /> 40 l IR 96 HR CONTRACT NO <br /> Standard X Contact US Prior S02317MOI SPECIAL REPORTING REQUIREMENTS (Specify) LAB USE ONLY LOT# Storage Location <br /> OJZer to Sending Sample ^ <br /> QAIQC Leveld' 1� <br /> Standard CLP ❑ Other C3 FAX ❑ FAX C 0 C W!REPORT WORK ORDER# LAB WORK RELEASE# <br /> Rehnquls y Sam Date ,� Time Received By <br /> 05- <br /> CUSTODY 137n,502-d By Sampler Data Time Received By <br /> RECORD <br /> Relinquished By Sampler Date Time Received a rratory <br /> Wa B111#�--�J l l2LZl�r� e rnQ <br /> SHIP SAMPLES BACK TO SPL INCORPORATED,8880 Interchange Drive Houston, TX 77054 Ph (713)660 0901 Fax {713)660 8975 Ph 1 800 969 6775 <br />