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� • Pe Pe I of� + <br /> Chain of CustodyRecordOil-site Time Q� Z Tenth' �I.'7 y- <br /> f bp Project Mime 11194 G"PV Mouitoring ^„ r_f--site lime 13'E!C Temp aLj� <br /> BP Bpi/GEM CO Por[folio: Adan(k Richfield Co. s canditioss. G <br /> BY lrrtboratory Conti net Number ------461000 Mcicarolo ical Events <br /> Rcqucsted Due Date(miofddlyY) IVind Speed <br /> ----- S <br /> p � Ducction <br /> SendTo.- _—. —_ - PICBM Facility No- 11194 'onsultant/Contractor• URS ^� r <br /> 6 Mine Sequoia Petaluma - PIGUM facility Address_ 2375 TRACY BLVD,TRACY,CA __ � _ ddress. 2870 Gateway Oaks Dr,Ste 300 f <br /> Lab Address. 1+455 N McDowell Blvd Stine D rtc 1D No 11194 `— - Sacramento,CA 95833 _ <br /> Petaluma,CA 94954 _ STtc Lat/Lon�, T _ _m_atl EDD doniso ea urscorp com <br /> 'alrromin Clobnl ID ff: 10607700011 _�- `— 'onxultant/ContractorPro eer No- <br /> ab pm Mike Giles _ P/CF-M 11mt Contact __ ~PAUL SUPPLE - onsultant Teleffrax 9116-079-20001916-Wig-2900 <br /> e!r_JT'ax 707-792-18651707-792-0342 Address P Q Box 8649 onsullant/Cantmctor PN, Jeff Broo <br /> Report Type&QC LeveL Levet I Re on&EDF iI Re utre Mora a,CA 94570 InI Consultant/Cmi(rar'lor B ICiEM dean,_ <br /> 3PIGEN4 Account Na- 404 6-21124 101dFax. 925-299-88911925-299-8872 1,PPIGEM Work Rcicase No <br /> all Bottle Order No- 610trix Preservatives Hcgriesicd Analysis <br /> in <br /> 145 <br /> licm g X Sample'Paint Laf/Lenr and <br /> yo SnuiplcDescription IabOrilOr}bNQ I P w d Sri <br /> 8 u h- $ F Comments <br /> 5 a �� J C3 ��+ td fa a 0 p!3v, Q z a ;x x C] 9 <br /> Dd cf� 7 _ 6J _ QVC �ktl� <br /> 2 11..7->t J _ )4 bv <br /> L?_ <br /> 3 ty1 L.! GASB --- — - — <br /> s MLJ <br /> ps <br /> s — <br /> lo <br /> arnpler`S Name i�. ALiamulshed I Iiat16R D_ste me cc ed R Atttlsatlou see Ime <br /> attt Tees Company. — $G�G __ fl 5 d �t _ _ ^4 .i'd <br /> 'i�incrit 1]ate: D 0 - 3h <br /> ;hent Method <br /> cni Trackug,No <br /> +tructions' Address Invoice to BFIGHNI butscad to URS for iirtarovnt <br /> RUN 82b0 ANAT.YT ES IN ONF.13ATCH ANAT,YSIS <br /> to Place Yes X_No — Temperature Blank Yes--gNo r Cooler Tempeiature on Receip[m2C Trtp 131ank Yes K No <br /> -n White Copy-Labomtory/YellowCopy-eYIGEM /PrrikC:opy-ConSWtant[ContrRCtOr aPCarRev 3 s2r15M <br />