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SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date: �s/tS/4i& <br /> Page e,/ �: 5 <br /> lN <br /> tao: - <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Ser , <br /> Site Address: Analysis RequiredffLAB <br /> CHECKf1?BOX ONLY CT/DT TURN A E <br /> WIC#: <br /> 7-0 Z ly r o s� 2, FLJC GrinU Q L461 ho <br /> Shell Engineer' Phone No.: atlon1 r—{ <br /> ,S/p-fj 7s G i7� 48 houn El <br /> Fax#:6 6171 <br /> Soil ClauUylfllpoeol ❑ t12 16 days2 , 0 � <br /> Consultant Name &Address: /iqy A, / l <br /> Warfellartnaq <br /> r\ Classify/Disposal ❑ 1147 Oih+r ❑ <br /> Consultant Contact Phone No.: = ' m Soil/Alt Rom or Sys. ❑ "S2 <br /> SIr7-1/ to-o 701 zz Cls SI ti a s M NOTE: Nohfy Lob as <br /> , Fax#:41 /7 e) 0 a Ln.- r T WO l Rem.of Sys, soon as Possible of <br /> 21 O ❑ 4451 24/46 his, TAT. <br /> Comments: N u' ^' <br /> C3 00 <br /> N in N <br /> Sampled by: c o a, as a o r� y UST AGENCY: <br /> a s EL a G '��4,, c o �}1 SAMPLE <br /> G L" w :� m a M jy �, "a a a MATERIAL <br /> Printed Name: a E CONDITION/ <br /> No.of x x W - o �� o a U DESCRIPTION COMMENTS <br /> Sample ID Date t salt Wales Air costs. 1= 1- i � °f "S U <br /> _ <br /> 15- <br /> - 7 <br /> � <br /> a - 7 <br /> ° - X <br /> I] �� L1IS <br /> � f Jf r, <br /> ted Name: Dales/6 ! eivvd sl�natu[e}; .�� Printed Nam®: , , pate: (, <br /> Poll8Y ahlrv): r r. .� v G <br /> Tl <br /> Data: na PTI ted Na Dafe: <br /> q y slflna v Printed lia", / / 6n Time: <br /> lin uEstled B ( G f ? �/e r� L� T'� Time: Prinled Name: Dale: <br /> t`? a Printed Na Dafa: vealvod( fl tv}: r < <br /> Rei y( }' Time: /1� Ttmv: <br /> RESU 11 I01 <br /> I&LA6&L-,,C/j (5-Irl - 13. g <br />