Laserfiche WebLink
a <br /> a -- .911111111L I <br /> SHELL OIL COMPANY IN OF CUSTODY RECORD Date "f1 3 <br /> RETAIL ENVIRONMENTAL ENGINEERING-WEST Serial No Page of <br /> Site Address Analysis Required LAB f f ��tt •� <br /> 11J <br /> WIC# CHECK ONE(1)BOX ONLY CT1DT TURN AROUND TIME <br /> 2y,4 y�4 L <br /> 4 GIN Monflodnp ❑ 4461 <br /> Shall Engineer Ai, ho .f�j <br /> No'� 75- I� I see ImreSrrpation IJ 4441 24 hours ElL`�N� L,41-0� r "^ � I 1-1 Sail Classlfy0sposal ❑ 4442 48 hours ❑ <br /> Consultant Mama&Address -,05 <br /> cm o wafer 15daye �Normalt <br /> (�. ^ � A bc, X Clasal1yl01sposal EI 4443 04her ❑ -- <br /> onsu taut Contact <br /> th hone No i SoIVAIr Rem or Sys <br /> � vL C V—�"��� —�'r o m 08 M ,4452 <br /> �� �aX (t1 Cp 06 ROTE NotMy lab as <br /> Water Rem or Sys soon as possible of <br /> Comments �y -CT v -o o d a 06M ❑ 4453 24/48hre TAT <br /> C, y Co Other ❑ <br /> Sampled by� jtGo � CO +n } UST AGENCY S %kG`' <br /> 0 9 <br /> Pentad Name L Jam- IJ w o ° Cd -M MATERIAL SAMPLE <br /> ,. m a CONDITION/ <br /> Sample ID Date Sludge Sail Water Air cr n st DESCRIPTION COMMENTS <br /> Nr <br /> yam <br /> I <br /> Rel nq stied By(sign j� Printed Nib �r. 1 Datecjj S ) A signtyre _ P5rt9dg� <br /> r -l- T" ��/ <br /> Time ( /� 1`--' Time r+� <br /> uis d B gna Pri Date , Reje ved(signature Printed Name ] !! Date ` <br /> Time 5` r l r t t t l �` I r1 l i I ) Time <br /> Relinquished By(signature) Printed Name Date Received(signature) Printed Name Date <br /> Time Time <br /> THE LABORATORY MUST PROVIDE A COPY OF THIS CHAIN-OF-CUSTODY WITH INVOICE AND RESULTS <br /> RFV 41u93 SHELL OIL COMPANY CHAIN OF CUSTODY <br />