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SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date <br /> RETAIL ENVIRONMENTAL. ENGINEERING -WEST Serial No <br /> � Site Address _ - --- - -- - Page � of <br /> I 1 ti' � 1_ Analysis Required LAB `?� ��C l 4t- <br /> CHECK ONE(r)BOX ON!Yi GPOT TURN AAOUNO TIME <br /> Shell Engineer t c W Monaann <br /> 1f� n g 4hoR�No LI= _�t� 0 11 4461l�h.,j 1,liT, , Fax SRo Invastigallon I I 4441 24 hours I I <br /> Consultant Name& Address 0 Sad ClassilytDisposal 1 1 4442 48 hours <br /> LL I [�-� r r N <br /> �L 6A )LC kU� �Lf4 V Tt.-1 U� Go W itur 16 d tys f` <br /> J ONWIJ <br /> Consultant Contact 1L___ X ClassifpljgM)�it I I 444 J I f <br /> - - - > f <br /> Pho a NO?t,- L11L _ w (I1har <br /> � .} IN� O h' Soil Air Rom or Sys <br /> r'tl�1- 1 ax 7� ( l�''SC 4 v� �T 06 O 8 M 1 I 4432 <br /> /� l [ tq () (V <br /> Comments � � - - - � -- - ��--- - (� © co � Wvar Rem or Sys e'! NOTE No1dy L ars 1s <br /> (V Y Soon as puss ble of <br /> p O w w 0 o d M 5 4453 24149 his TAT <br /> Sampled by 1.� t - -- - — - o N r Wier [ I <br /> a d <br /> 00 Q CO CD <br /> _o, U) <br /> C t' r UST AGENCY S� <br /> Printed Name I t _ I' d��'�F, A ro <br /> IL a EL O N ° 2 -- - <br /> - - -- w w x m r` MATEF�IAI SAMPLE <br /> Sample ID Date Sludge Soil Water Air E D c E CONDITION, <br /> _ No <br /> � � �` o a) a rn a DESCRIPTION COMMENTS <br /> I— m > t— U ¢ U a <br /> R In cashed By{s1 re <br /> gel Print ame Dale ' I - '� (signature) Pn ted Name <br /> )!! � Rec rued <br /> 1 Punted Name - 11�1 /_( Date Sz <br /> R li gwshed y(sig ature r <br /> Time — 1��,�� � � �« !� �l4 �� <br /> y� [ Date /i / FQe7celved( r fed me /r l Time <br /> Li---A( �� re)(1�� _ ��/l�� ii Time !�0 `� �' � / Date s <br /> Relinquished 8y(signature) Printed Name - f fr�zf tr Time z '-S <br /> I Date Received(signature) Primed Name bate - - <br /> _ Time <br /> REV 411193_ — THE LABORATORY_ MUST PROVIDE A COPY OF THIS CHAIN OF CUSTODY WITH INVOICE AND RESULTS lime <br /> SHELL OIL COMPANY CHAIN OF CUSTODY <br />