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jjF } <br /> ii e <br /> Fax copiwf Lab Report and COC to Chevron Con& El No Chain—'Of—'Cusfo RBQOC{ <br /> I, Chevron Faelllly Number--9=4215- — Chevron Contact (Name) <br /> h Facility Address 2905 W. Reniamin Tint r lir_- -- (425) 842-8695 <br /> (Phone) <br /> Chevron Praduc13 CO. <br /> 80X 6044 Conaultant ProJacl (lumber Laboratory Name SEQUOIA <br /> Phe <br /> BLAINE TECH SERVICE, INC, <br /> Sa9144`48$ <br /> lne Ramon, CA 94583 Consultant Name Laboratory Service Order <br /> FAX (925)942-9370 Addreea.. 1680 ROGERS—A—VE.--- ! SAN JOSE Laboratory Servlca Cade ZZ021800 <br /> h ProJacl Contact (Name) ISTI E LILLIE Somples Collected b (Nome) 6A ff! <br /> 4 <br /> (Phone) (Fox Number 408-573-0555 e08—')73T7771 <br /> � signature <br /> State Method. ❑ C)N ❑ OR ❑ WA ❑ Series ❑ CO ❑ UT Remarks <br /> ' � a <br /> 6 t1 tl <br /> 8 $ a uti �S p` <br /> Il w+ <br /> DO r a u c7r r, n <br /> ri x ul <br /> Lab Sampla No <br /> MW l 34a <br /> "A W 3 i33u <br /> c3 <br /> k r 134 lij, !9 IL <br /> A W ZS <br /> IIAM W`7 1403 _ <br /> q1 <br /> p bmf <br /> r, <br /> Reil 13uia d (Signature) Organization Dale/ilmq� ��, Received By (SI nalure� �ganlzatlon Dale/Tim�Z �a iced Y/N 1 Turn Around Tlme (Circie Choice) <br /> 24 Lira <br /> R Ilnq ed By Slgnatur Organization Date/Timo Received By (Signature) Organization Dale/Time Icad Y/N 4B Hre <br /> r q /¢ <br /> p vI'l' .0 -1 U' �� I 3 Days <br /> l0 Days <br /> J <br /> Re <br /> ll shad By (Slgnatur Organization Date/Tlme Reclaved For Laboratory By (Signature) Oat /31 Iced YIN <br /> ,�Y � As Contracted <br />