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COMPANY CHAIN OF CUSTODY RECORD <br /> SHELL OIL CO Date <br /> RETAIL. ENVIRONMENTAL ENGINEERING-WEST Serial No Page of <br /> Site Address T <br /> 6L ---- — -- - Analysis Required ----- LAB -�W(�&Y_A --- <br /> WIC# l <br /> CHECK ONE(ti BOL(ONLYI CTrDT TURN AROUND TIME <br /> G W Mondonng [] 4461 <br /> Shell Engineer Phone No 47 -fyt `� si,elnvesilgauon El 4"1 <br /> 24houm LJ <br /> L`l{SIJ ��!�1��' — a# �r5__+7_ 4e hours ❑ <br /> Sail classdyroisposa! L7 a44z <br /> Consultant Name& Address es— N <br /> 15 days &(NorrTW) <br /> O Water <br /> C t�� 1 T�_ Sid �_L'L� ILLS YL,) 1 X aassirylDisposal l 1 4443 Other 11 <br /> Consultant Contact Phone No 7(-�-y lL ' -- o Uj Soil/Alr Rem or Sys <br /> �AUL �]Ily , m v rXl <br /> O&M 4452 <br /> Fax i� �`� 7r�c r ro m eta NOTE Notify Lab as <br /> C9 p Wager Rem or Sys soon as possible or <br /> Comments �4(; N d r0 Dam 17 4453 2414ehrs TAT <br /> �f 1'Lit 1 00 <br /> C-,V� l �i" 1 V1� ��J C)in C\IN = Other C� <br /> Sampled by t2 Co in Z - - --� <br /> a o 6N :D C UST AGENCY Si,% 'yl ) c'C <br /> a a w o <br /> Printed Name 7� "� I A �� -- — LE <br /> - --- - - - -- — — - <br /> ---- w O n m DESCRIPTION CONDITION/u) S 8- MATERIAL <br /> Sample ID Data Sludge Soil Water Air N° °I a- a- m o � 0 fi COMMENTS <br /> conts <br /> Wit—�i LkF — -- — _ — u5T �,4'/AIS <br /> i7ehn uted B (sign ) PrinTteiiNPm�e y Date 1 '(3 Recd(si tur_ Printed Name Date <br /> -- I F rte- _ JAW TimO &y. _�— G Time / _o <br /> Retro sh 8 azure) Printed Name Date f Received(sign lure) Printed NameA + '� Dale tf <br /> p—��� G L C Time !Z .S d A ^!\ �A�Q[7 �1��u4� __� TimeRelinquished y(sig ure) Printed Name Date Received ignalure) Printed Name Date <br /> Time Time <br /> THE LABORATORY MUST PROVIDE A COPY OF THIS CHAIN OF CUSTODY WITH INVOICE AND RESULTS— <br /> REV <br /> ESULTS_ <br /> REV 41IM3 — — SHELL OIL COMPANY CHAIN OF CUSTODY <br />