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OU Yes /�,��'� [��'UFax co y of Lab Report and COC to Chevron Contact ❑ No r Chain-of-Custody-Record <br /> Chevron Facility Number 9-1848 1Chevron Contact Name) Brett Hunter • <br /> Chevron Products Co Facility Address 1257 Yosemite W Manteca <br /> � Y, (Phone) (925) 842-8695 <br /> P O BOX 6004 Consultant Protect Numberq ( `L'�- Laboratory Name Sequoia <br /> San Ramon, CA 94583 Consultant Name Blaine Tech Services, Inc Laboratory Service Order 9144488 <br /> FAX(925)842-8370 Address 1680 Rogers Ave, San Jose Laboratory Service Code ZZ02790 <br /> Protect Contact(Name) Scott BOOT <br /> Samples collected by(Name) <br /> (Phone) 408-573-0555 (Fax) 408-573-7771 Signature <br /> State Method ❑ CA ❑ OR ❑ WA ❑ NW Series ❑ CO ❑ UT Remarks <br /> UCn <br /> fn <br /> QU m a.2 ui y ¢ r a <br /> C QU � � Q _ o bl oZ 0 <br /> E U H + + � "' 79 21 �; a z <br /> ` LCI S Q m z O m Q N L •�• <br /> Z O N Q W I_ d N +�+ N N 41 C7 L ❑ K <br /> U7 k N M V <br /> M ?SO _ C M <br /> E E `err E LUN LCL il04 r � a� rn� rn� � Q � � mU Xo Xo S ❑ <br /> _ LU N LU N 2 <br /> "�� z �� o m ° � � ° om a aS wS o � � o m ! mS Lab Sample No <br /> IV73 <br /> EFE1 F <br /> �'-z W �� 1rt tsts X <br /> C- 3 3 W ct X13 ty X <br /> iWR <br /> (S nature) Organization Q te/Trme Re rued By(Srgnatur Organization Date Im Iced YINTum Around Ttme(Circle One) <br /> ls:s► 1 �� 24 Hrs <br /> (Signature) Organization � lTrm Received B I ture) Organ¢at n D te1Tl aIced YIN 48 Hrs <br /> 25 flays <br /> o (S at <br /> Organization D to a Re ad For Labora ey(Signature) Date/Tlme Iced Y!N 10 Days <br /> As Contracted <br />