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Fax 2& of Lab Report and COC to Chevron G act, 11 No- <br /> Cd —0 —Cus = CO 1 <br /> Chevron Facility }lumbar — �^ (Rama)BRETT HUNTER <br /> Chevron Contact <br /> Facility Addr6ee 575 Grant Line Rd, , Tracy (P 00(925) 842--8695 <br /> C(IBVF�n �'fO(111Cj� LU. I f�0/ Y� Laboratory SEQUOIA <br /> P.O, 30X $l70q Coneuinani Pra act Numb6r_ Laborato llama <br /> Consultant 110me BLAINE TECH SERVICES, INC. Laboratory Servfoe Order _91144AR <br /> Son Ramon, CA 94583 1680 ROGERS AVE. SAN JOSE <br /> FAx (925)842-8370 Addreee laboratory S6rvlce Coda Zz02800 <br /> Project Contact (Ham6) CHRISTINE LILLIE Samples Collected by (Hama) rK°!!l--- <br /> ) <br /> (Phone 408-573--0555 (Fax Namber) 4013--573-777.1 <br /> Signature <br /> Stake Method, ❑ CA ❑ OR ❑ WA ❑ NW Series ❑ CO ❑ UT Ramarke <br /> j; � <br /> o <br /> g x u <br /> 13 <br /> I <br /> Lab Sample Ho <br /> Soya 1210 C-p1t5"f-MTFe-) Ec <br /> t <br /> Reitnquhhad By (Slgnalure) Organization Date/lima }l ' Received By (Signa a Organization pala/ifine//% Iced Vii Turn Around Tlme (Circle Choice) <br /> i� <br /> 24 lire <br /> Nnqu had By 51 urs) OrganlzatlanDolefTlma Received fly (Sfgnatura) 719-all.-II.- Oaie/lime Iced Y/1149 ilrt <br /> 5 nays <br /> 10 nays <br /> julzhed fly (519natura) Organlzallon Val e/iln a Recleved For aboratory By (Signature) Pala/llms iced Y/11 An Conlracled <br />