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Pigg 3 of 3 <br /> '. Chain of Custody Record On-site Bine Temlr- . <br /> Project Name 2Q04 Groundwater Sampling Event� off-site Tiine- Tcmp <br /> 1 <br /> 31' 131]/G lir CO Portfolio: Atlantic Richfield Company Sky Conditions <br /> T3P Luboi tltol y Contract Number: _ -j& j p b b MOcorological Events* <br /> Date. Requested Due Dale(nuWildiyy-- lWind Speed Direction <br /> Send To, BPIGEM Facility Aso_ ARM Station 2l 3 Consultant/Contractor SECOR <br /> [Ab Name SEQUOIA ANALYTICAL BPlGEM Factlliy Address: 290811enjanil' liolt Dr, Address 3017 M1goi a ltd.,Ste 100 <br /> [Ab Address 8S5 Janis Prlve Site ID No Rancho Cord o3 a,CA 93670 <br /> Morgan 111115 CA 95037 Site Lat/Long ;351-1.21.3 email EDD: kflesDras@secor.com <br /> com <br /> Califomia Global lM 70607700002 Consultant/Contractor Project No 77BP 52133 0;0327 <br /> l.ab PM Roo Dube](Sacramento Office UPIGEM PM Contact Patti Supple ConsultantiContraclor TelelFax 916 8610410 <br /> leldPax 916 9219600 Address. P.O.Box 6249 ConsultantlContraclor PM R Pwilsosky <br /> Report'lype&QC JL Kel Alora n,CA 94570 Invoice to Con entlC n tar or BPIGF M Circle one <br /> B151613M AccouatNo- 1'e cNax (925}299 8891 WGHM Work Re se No <br /> l ab RoWc OrdcrNo Matrix Preservatives *ry{ Requested Analysis rl� <br /> l N M F t�T3 <br /> PQ C u -i <br /> ]teni b Sample Polttt Laff,ong axd <br /> Saiuple Description Tiute -0 Lab NoV. m <br /> No. a g w'M Comments <br /> a <br /> 1 MVI(--2 ------------------- -------------------------------------------INACT 38 00432111-121349915 <br /> 2 MW-3 ----------- ------�-----------—______,_.__.----------------INACT 38 00443051-121349863 <br /> 3 MW-4 ------------------------------------------------______--_-1NAC1' 3B 004396151-12'1 349833 <br /> 4 MW-5 ---------------—_------------–__._-_-___-_---------------- AcT 38,00454221-121349872 <br /> 5 QCTE1 x a,v x x 3B 004447,31-421350204 <br /> 6 38 0044238)-121349667 <br /> 7 38 00454681-121 349803 <br /> 8 38 00475361-121 340887 <br /> Sampler's Na r161tiqulshed llyl Aflibahan me Accepted Iiy!ArMladonqD.le <br /> rima I� <br /> Sani rler's Company. <br /> Shi rent Tate, U '16,�i•d`Ir <br /> Shi ment Method a o/z— <br /> Slnprivnl'1'cackwg No <br /> %l Mal Insfruetious: <br /> Ay Seals lir Place Yes Na k, Tetnperature Blank Yes _Nok No <br /> Nstnbitl;olr Wlitic Copy-Laboratory 1 YeIIow Copy-BPIGEM /fink Copy-Consu lant/contractor ftp coc Rey i 215M <br />