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SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date- q ` <br /> RETAIL ENVIRONMENTAL ENGINEERING •WEST Serial No ' Page o1 <br /> sJto Address- Analysis Required LAB: 5EQk5Dlx <br /> ICN: CHECK UNH(lI Bolt ONLY orlDT TURN AROUND TIME <br /> 2-0L�'`7 S2S-01 0 Monloring ❑ uet <br /> S e ff Sng nowr; o s No d 5 coc sie a v9611g,a,,, O Oar 28�"` ❑ <br /> L-A N 0 w �?a,xtf Ga`] - 2. Sol Cl...arra.ao.,+ {J 4u2 <br /> �e how, C1 <br /> Consullint Name&Address:�z t,4 Pb wl ST- l W N le d.y. &iormrdl <br /> EL S7� V I'LL, . �S(o1� °D Cla4alyasporal ❑ 4413 Mot Cl <br /> ia � ���Rom as� 44e2nsuContact: R (Db <br /> !so xHOTEt Wily Lob u <br /> a .7 <br /> wtl.r t1.m of 6Y$ .non as pwsble ar <br />' r Comments: -w ISH 9 o s a ❑ 44e3 244e►i. IAT <br />�) ) " oktler ❑ <br /> t' <br /> Sampled0 UST ACFNCY <br /> :-S � ► <br /> t <br /> ao: CLSAMPLEPrinted MATERIAL <br /> CONDITION/ <br /> C <br /> N ,of z E DESCIPTION <br /> Sample ID Date Sludge sop Water Air o COMMENTS <br /> CDii1e t <br /> 1 <br /> I <br /> IL <br /> I <br /> 1-1 f I J- <br /> nal ulahed By(elp g) PiIn1jtd Nems Dale ` S Ile <br /> alure) Prl stns 11__ - Dats <br /> Time C J��� Time <br /> P�iohed <br /> eig ON ) Pr1 I Date ec ved I nature) Printed Name! CkA� Time Time <br /> y(signature) Printed Neme Date Receive (a[gnalure) rFt"fnteaNama Dale <br /> Time �� ��yia,,t,,L Time C q(a <br /> THE LABORATORY MUST PROVIDE A COPV OFTF S r AIN nF• . ISTr)[lY WIT4�INVOIC1=ANn RFRI11 TR <br />