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mccampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br />1534 Willow Pass Rd. / Pittsburg, CA 94565-1701 OND TIME: RTJsIi t DAY z DAYDAv [a s DAY <br />www.mccampbell.com / main@mecampbeiLcom Geo acker EDF Q PDF Q EDD (5 Write Oil (DW) U EQulS ( 10 DAY <br />Telephone: (877) 252-9262 / Fax: (925) 252-9269 ` V <br />1 �I FMuent Sample Requiring "d" flag (J UST Clenn t)p Fund Project 0; Claim ff <br />Report To: Kiersten Hoey Bill To: _G_HD -Kiersten Hoey Analysis Request <br />5900 Hollis S1 <br />Tele: 1510 1 420-3347 <br />Location: 1930 W. 11 <br />SAMPLE ID <br />ite A, Emeryville, CA 9 <br />E -M <br />Fro e <br />' <br />to St 1'r _'A Purc <br />SAMPLING <br />Locallon! <br />-leid Pnin <br />!name Date Time <br />J <br />4608 o <br />ail: Kiemten.hoey@ hd.com < <br />ct Name: Chevron 201383 <br />base Order# 34004571 <br />- x � <br />e• <br />MATRIX NIET1I01) 3 U <br />PRESERVED ' <br />E <br />� m o <br />2 <br />3 a ,X us o sI o ` f= <br />N <br />N <br />12 <br />a <br />,off <br />D 7/6 3 <br />!©:25 <br />1 <br />X <br />x <br />� <br />a <br />� <br />•a <br />U <br />O <br />� <br />0. <br />`O <br />- <br />� <br />k <br />x <br />x <br />x <br />C: <br />7. <br />.0 <br />r4 <br />m <br />$ <br />E <br />0. <br />x <br />qq� <br />M <br />N <br />N <br />••MAI eltents MUST disclose any dangerous chemicals known to be present In their submitted samples In concentrations that may cause Immediate harm or serious future health endangerment as a result of brief, gloved, open air, sample <br />handling by MAI stall. Non -disclosure Incurs an immediate $250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing us to work safely. <br />'•' it metals are requested for water snm les and the water INYa Is not specified on the chain of custody. then MAI will default to metals by E200.8. <br />Relinquished By: Dnihy Time: Receilec TCE./P COUINIFN'1'S: <br />-"--f <br />. % J( OD CONDITION <br />I / / •'u IIEADSPACEABSENT <br />R lingnished Ry: ante: Time: Receiv DECIILORINATF.D IN LAB <br />APPROPRIA'T'E CONTAINERS <br />I'RFSFRVF,D IN LAB <br />Relinquished By: Date: Time: Received By: VOAS O&G MKTALS OTHER IIAZARDOUS: <br />PRESERVATION p1I<2 <br />Page 19 of 20 <br />D 7/6 3 <br />!©:25 <br />1 <br />X <br />x <br />- <br />� <br />k <br />x <br />x <br />x <br />_i7 11h2 <br />••MAI eltents MUST disclose any dangerous chemicals known to be present In their submitted samples In concentrations that may cause Immediate harm or serious future health endangerment as a result of brief, gloved, open air, sample <br />handling by MAI stall. Non -disclosure Incurs an immediate $250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing us to work safely. <br />'•' it metals are requested for water snm les and the water INYa Is not specified on the chain of custody. then MAI will default to metals by E200.8. <br />Relinquished By: Dnihy Time: Receilec TCE./P COUINIFN'1'S: <br />-"--f <br />. % J( OD CONDITION <br />I / / •'u IIEADSPACEABSENT <br />R lingnished Ry: ante: Time: Receiv DECIILORINATF.D IN LAB <br />APPROPRIA'T'E CONTAINERS <br />I'RFSFRVF,D IN LAB <br />Relinquished By: Date: Time: Received By: VOAS O&G MKTALS OTHER IIAZARDOUS: <br />PRESERVATION p1I<2 <br />Page 19 of 20 <br />