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Chain of Custody Record Page af? <br /> t Project Name: ARCO 2168 RAP Im iementation On-site Time: 0 '1 :aa Tens : & � <br /> BP BU/AR Region/Enfos Segment-� gmBP>Americas>West Coast>Relat>t+VCBU>CA Off-site Time: Temp: <br /> >Cen1ral>21M>Hislari aRL Ery Conditions: Clear <br /> State or Lead Regulatory Agency: Sao Joaquin County Envionmental Managament Dept Imetcorological Events: ry v_e_ <br /> Requested Due Date(mm/dd/yy): 1j ! d� { Wind Speed: Direction: <br /> abName,Sequoia BP/ARPacili No.: 2168 Consultant/Contractor: URS <br /> Address:885 Jarvis Drive QP/AR FacilityAddmss:441 W Charter Way,Stockton CA 95206 Address: 2870 Gateway Oaks Drive Suite 300 <br /> Morgan Hill,CA 95037 Site Lat/A o : N/A Sacramento CA 95833 <br /> ab PM:Lisa Race California Global ID No.: T0607700508 Consultant/Contractor Project No.: 38466562.0093001 <br /> Tele/Fax:408,782.8156/408.782.6308 8nfos Project No.: GOCSI-0010 onsultant/Contracwr PM: Vemon Elarth <br /> MAR PM Contact:IC ie Christie Provision or RCGP: Provision ele/Fax: 916-717.5045 1916.679.2900 <br /> Address:4 Conte ointe Drive PhaseJWBS: 09-RAP Implementation Report Type 8c C Level: Level 1 with EDF <br /> La Palma,CA 90623-1066 ub Phase/Task: 03-Anal ical -mail EDD To: Denise Y ;usco .com <br /> ele/Pax:714.670.53031714.670.5195 Cost Element: 05-Subcontracted Costs Invoice to: Altantic Richfiel <br /> Lab Bottle Order No: Matrix Preservative Requested Analysis <br /> b <br /> X o PDX 6 <br /> 1Nu Sample Description a 'd Laboratory No. �' tl o <br /> p o [g u a Jt o nt Lat/Long and Corn men <br /> C d v <br /> � <br /> 2 Tf#`oL1fo$-/ is as_ pd fit, 64 LD <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Sampler's Name: tKai, Rciin uishedBy/Affitiation Date Time Accepted By/Af Uatlon Date Time <br /> Sam lees Cam an . t?S fJ / s �;p <br /> Shi ment Date: k1 f O <br /> Shi ment Method: &t e l?,ytr <br /> Shipment TrackinNo: M <br /> Special Instructions: e- <br /> �, t <br /> _T.F b S 'T?�LQ x p 5 5 T <br /> Custody Seals In Place Yes No Temp Blank Yes No Cooler Temperature on Receipt °FIC Trip Blank Yes No <br /> Distribution: White Copy-Laboratory/Yellow Copy-BP/Atlantic Richfield Co. 1 Pink Copy-ConsultanttContractor HP COC Rev.4 10/1104 <br />