Laserfiche WebLink
LL OIL COMPANY WAIN OF CUSTODY RECORD Date. lif-I L7 <br /> R IL. ENVIRONMENTAL, ENGINEERING - WEST Serial No: Page t of <br /> Site Address: ,3 I pa�� � A-4e ? S <br /> Analysis Required t)g�,c, LAB: _ SQ�c�g <br /> ICI: I ._ <br /> 204 G f +e 7 r h Z2q r b t03 CHECK ONE 101 OX ONLY Ci/Pi YUAN AROUND AUIF <br /> Shell Engineer: V C.r P nne ..o.• GW Idanlla�lnU [� ���> 24 hours <br /> ❑ <br /> G P - -�, fax :f.75—r17,2— llnlnvodlpallon �t/1 <br /> � 46 haw [l <br /> Consultant Name&Address: 59 � SaUClanUy/D4posal ❑ u�� �' <br /> P.O. Box 2 ILdays rHwman <br /> Enviros Inc. , Sonoma CA 5476 _ water <br /> 0 p^ ► Claul:y/d><po�al 4113 ❑ <br /> Consultant Contact; Ph e N '7 � LLUU ah•� <br /> /' f 1 _ 9' 49* ^ �cV to <br /> 3oIIlAb R.rs►a Sys �Ii7 <br /> L� CL Q/ FdX :9 3 _�6�� Q O a Al NOTE Notify lob as <br /> Comments: <br /> a a Waferpun.orsyr arpool mear <br /> Yf Yj �: d A M ❑ 4463 91/U his IAT <br /> O O <br /> 013 <br /> Sampled by: 7 6. A a I z Clh.r ❑ <br /> � ` a 2 0 N c a UST AGENCY: <br /> Printed Name• • ra qc�r- Q �' N <br /> °M 1 m <br /> n. u MATERIAL <br /> SAMPLE <br /> u" a ESample ID Dare ° o � a DESCRIPTION CONDITION/N/ <br /> COMMENTS <br /> -- <br />� <br /> Rs n D pna e): Pr a i umq. - Dale. c� ReceN d(Slpnalufa). �P�sllni <br /> lati Name; <br /> �� ' A Dale:9 i}} <br /> By(Sip e): NIn r me: Dale.g Roc ed(clgnalure): '� led Name:WUalle: <br /> hed <br /> by ap atule); Printed Name; Dale: Received(>:lgn ). Pdaled N e; pale: <br /> )L —JURABORAYORY UST PRQVIDE A COPY QE-11112- ,c <br /> ewarrnn w .way <br />