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80 hesapeake Dr j <br /> wood City, CA 94063 Lu I P O Box 2180 , <br /> , Hou TX 77002-7426 <br /> (a15}364 9600 • FAX(415)384 9233 C\� CHAIN OF CUSTODY <br /> ffAddress <br /> 's Name r4 �� /n���n` � ,,r <br /> lP���;�> r� Page / of <br /> �-c SiteLocation Consultant Pra ect# �j .� IQf� Consultant Work Release #tact Cyd rts�r- ,, + Phone # Laborator <br /> 7a i—7 Y Work Release# <br /> c <br /> EXXON Contact Phone # � <br /> .tzm4 (fit_ �S ,,_q4- S� (o EXXON RAS# "7- <br /> Sampled by (pant) �t5 t�6c Sampler's Signature 7/�Vv, <br /> Shipment Methodc <br /> �ouo(�4 Air Bill # <br /> TAT ❑ 24 hr ❑ 48 hr ❑ 72 hr ❑ 96 hr Standard (10 day) }gyp ANALYSIS REQUIRED <br /> Sample Collection Collection Matrix # of Se uola's TPH/Gas TPH/ TRPH SZ�o <br /> Description Date Time Soil/WatedDiesel <br /> Cont Sample # s^�Arr Prsv BTEX/ 7emperatura <br /> 8015/ EPA 5520 inbovnd Seal Yes No <br /> 802,0,..77 8015 Outbound Seal Yes No <br /> r,K Q <br /> tT <br /> U) <br /> �v11� lie �r <br /> !�w 7 y 6>5- <br /> 1 ro <br /> kr c%(/ ' tL S f o <br /> Cr <br /> 07 <br /> X7'1 vl 1 Z3 Z� 1 <br /> 71RELINQUISHED BY/AFFILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> -�'–����,U✓rte, �ZQ_— �S�zy/2�S '�Sof �e � — ��� ���' � 5 Y <br />