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HELL OIL COMPANY CHAIN OF CUSTODY RECORD bale: <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Sonal No page J of 1 <br /> Silo Address: <br /> wlc#: 3725 S. Tracy Blvd. , Tracy Analysis Required LAB: <br /> 204-7884-0901 CNECK ONE(1)fox ONLY CT/DT TURN AROUND TIME <br /> Shell Engineer: Phone No.: 510 ow blonvor4,g )9 "11 <br /> Alex Perez �1• ^ Sll <br /> 24houn ❑675-6168 <br /> Fax _ <br /> As houn <br /> Consultant Name &Address- <br /> ❑ <br /> Blaine Tech Services, Inc. �f N SOP CIO" ❑ "42 <br /> 1680 Rogers Ave. San Jose CA 95112 X l6dayi�(Normao <br /> wets <br /> Consultant Conl'acl: P oneNo: (408 0 � eb,rw/aaparal C] <br /> NO: oih.r ❑ <br /> Fran Thie 573-0555 w � N to t Solf/AfrR.rnarSyr <br /> Fax rr 573-7771 a 0, .n *� Ohm ❑ "S2 <br /> Comments. 0 a ¢ v \ NOT[ No6iytab asWale# , <br /> C) u O O o h m Ram or Syr roafl h s At of <br /> ��\f a o o N s h o a!a ❑ 4]3] ]</ae her ut <br /> Sampled by. N N a '� �. Olhor ❑ <br /> e co yr a n <br /> 2 in C UST AGENCY: <br /> w `° M d <br /> Printed Name: r h `�. Y�? "- ! ¢ ¢ a O s o °f „ <br /> a a. w m <br /> UJ 0 o SAMPLE <br /> Sample ID Dale Sludge Soll Wolof Ali NO Of x x b E r a MATERIAL <br /> coni: m � U U 0 DESCRIPTION CONDITION/ <br /> COMMENTS <br /> )� f"''t`✓-�� ray � � x x i <br /> X x <br /> �Jvl� < X x <br /> Relin ul d B (sJgnalute), Prp¢Name, <br /> • <br /> al ale ( Ro�lv�(slgn-�aiure) Prine{�EooNva <br /> Daleimo Gl <br /> Dolo " . l/ Time.u!s y(sgnaluro) Prinlad Name URely d�s1 noluro) Prinled Nama <br /> 2 <br /> DaIB ' <br /> Time II/ <br /> R n ulshed By(signature) Prinled Name Dolo Rocoivod(signaluro) I Prinlod Nain limo <br /> o _ 1 n <br /> Q U <br /> Tlmo 71q' � t�� �� � Dolo <br /> lime f <br /> LABQRATORY MUTn C <br />