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. Page J o Y <br /> ' , Chain of Custody Record Temp: <br /> On-site Time: i <br /> # Project Name ARCO 5450 GW Monitoring Off-site Time: 610/— rem : ?4� <br /> r,3,,040 BP <br /> •tt li Retail �e%z r& <br /> 04 BP .BU/GE.N. COCQ Po fo D: Sky Conditions: <br /> BP.Laboratory Contract Number: Atlantic Richfield Co. Imaeorological Events: <br /> Date: f It 16/03 T T Requested Due Date(mm/dd/yy) Wind Speed: Direction: <br /> Send To: BP/GEM Facility No.: ARCO 5450 _ Consultant/Contractor: URS <br /> Lab Name: SEQUOIA 13P/GEM Facility Address: 1617 W. FREMONT ST, STOCKTON,CAAddress: 2870 Gateway Oaks Dr., Ste 300 <br /> 1 ab Address: 1455 N. McDowell Blvd. Suite D Site IIS No. ARCO 5450 Sacramento, CA 95833 <br /> Petaluma,CA 94954 Site Lat/Lon : -mail EDD: denise ee ursco .cam <br /> alifornia Global IB 70607791886 Consultant/Contractor Project No.: <br /> Lab PM: An elee CadBP/GEM PM Contact: PAUL. SUPPLE Consultant Tele/Fax: 916-679-2387 1916-679-2900 <br /> Tele/Fav 707-792-18651707-792-0342 Address: P.O. Box 6549 onsultant/Contractor PM: VERN E <br /> e rt T e& C Level:Level I Mora a, CA 94570 invoice to: Consul tant/Contractor BP/GEM ircle one) <br /> BP/GEM Account No.: ale/Fax: 925-299-88911925-299-8872 P/GEM Work Release No: <br /> Lab Bottle Order No: Matrix Preservatives Requested Analysis <br /> o °° to <br /> Item No. Sample Description Time ;a <br /> Laboratory No. co � a ¢ Sample Point Lat/i ong and <br /> 3 O o © z � Comments <br /> o O `� -- ims; <br /> yy Y N <br /> C/3 7 V: -,4 z-. .moi .�i-i t-" Q0 w ... ao <br /> 1 'Z /6/0 6 <br /> 2 ✓✓ <br /> 3 /lye,/ t'/ I'SO <br /> 4 <br /> S <br /> 6 <br /> 7 C,OOLE4 C 'ST® YL <br /> 9 0 <br /> 10 <br /> Sampler's Nam /4Aee— Relinclujed ByJ Affiliation ate Time AcC <br /> il 13 1 Affiliation Date Time <br /> Sam ler's Company: w-le z fl - C tU4j <br /> Ship meet Date: <br /> Shi ment Method: t;- )� <br /> Shi ment Tracking No: N11 �— <br /> Special instructions: Address Invoice to BP/GEM but senkltR URS for app?oval -If total lead*slue is>5 nalyze for lead by STLC,value is>5 analyze for lead by TCLP <br /> RUN 8260.ANALYTES IN ONE BWrCH ANALYSIS <br /> Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt F/C Trip Blank Yes Wto <br /> Distribution: White Copy-Laboratory/Yellow Copy-BP/GEM /Pink Copy-ConsultantlContmecor 6P COC Rev.1 2!5!02 <br />