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Date/Time <br />Date/Time .1/15 <br />Received by (Signature) <br />Received by (Signature) ( <br />Received by (signature) <br />2- <br />Date/Time <br />O WORLD OIL <br />RECYCLING,. <br />G4-DHS ELAP Certificate #24937 <br />DeMenno/Kerdoon dba World Oil Recycling <br />'Recycling for a Cleaner Environment" <br />2000 North Alameda Street, Compton, CA 90222 <br />Ph (310)537-7100 Fax (310)639-1254 <br />Chain of Custody <br />Date Page 1 of 1 <br />Client: CENTRAL VALLEY WASTE SERVICES CEN644 Contact: JOSH MALONEY <br /> <br />Tel: 209-333-5655 <br /> Fax: <br />Address: 1333 E. TURNER ROAD City: Lou State: CA Zip Code: 95240 <br />Project Name: SUMP WATER Sampler(s) Signature: <br />Project Manager: SAM READ Approved By: <br />Due Date lei Regular I:1 Rush Days Comments: / VACUUM <br />Sample Description <br />Lab <br />ID <br />Date Time <br />Collected Matrix <br />No. of <br />Containers Analysis Requested <br />SUMP WATER ),,i2e, lon-k-t LIQUID 1 TPH as gasoline, diesel, and motor oil <br />CAM 17 METALS <br />1 111111111111111111 11 <br />BTEX <br />DR 0000009829 % OF SOLIDS <br />ACCOUNT: CEN644 <br />CAL000194471 <br />EXPIRES: 10-13-22 <br />Sample Conditions: Seal Intqct Ui Broken j None; Temperature j Cold f Room; Other <br />Relinquished by (signature) <br />Relinquished by (signature) <br />Relinquished by (signature) <br />SPECIAL INSTRUCTIONS <br />E-mail results to: dboyd@worldoilcorp.com / emcgovney@worldoilcorp.com ; sread@worldoilcorp.com