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Fax co of Lab Report and COC to Chevron Co t: ❑ No Chgl -Of`-'CuSfO Record <br /> Chevron FaclUty Number <br /> 9--4183 Chevron Contact (Nemo) Brett Hunter <br /> 236 N. Ham Lane, Lodi, CA (510) 842-8695 <br /> Faoflfty Address— (Phony) <br /> Chevron U.S.A. Inc. consultant Project Number ��t� Z`L _ .-- —.. — Se uoia <br /> Laboratory Name <br /> P.o BOX 5004 9 <br /> Consultant Name Blaine, Tech Services, tnc.X85 <br /> San Ramon, CA 94583 c r133 - Laboratory Release Number 4568891 <br /> Timochy Dr. , San ,lost, CA 95 <br /> Address Samples Collected b Mamo ,- <br /> FAX (415)842-9593 <br /> P y (Noma) / <br /> Pro,oct Contact (Mame) Jim Keller Colleotlon Dote 2-6-7, 4 <br /> (Phon*YLQR 995-5535_(Fox Number)_1JH.. _J_-8113__ Signature <br /> Analyses To Be Performed <br /> L M DO NOT HILL <br /> ZU 0-r o <br /> Z �a u 6 z � g pEp E' FOR TB-LB <br /> 1 f = 7s $ x v 0 o f <br /> o £ via ° f F °u1 tiU �o Do �p�p �qn 0. ° Q r} D(�(� <br /> E A a 1 1 f f o t; tx�w °`r� 'ago �"a�a L>21 <br /> 21 <br /> t91 .° x 1n 3e r K V{ `_' tef.`°. F-� OV CL a. <br /> �� ,/ Remarits <br /> 04 �'C VY 7 <br /> 02 <br /> 0� 3 )00 P <br /> Dj A4i Z .r <br /> -- TZ> RhkW'7rA0, <br /> P <br /> i <br /> i <br /> ¢ Rsllnqufshed By (Signature) Organization Dats/flmo Rooelved By (Signature) OrganNatlon Dotatnms Tum Around lime (Clrels Choloe) <br /> 0 <br /> �S 24 Etre. <br /> Re1[nqu[shod By nature) Organization Dotstn s Received By (Signature) Organization Dote/Time 48 }ire. <br /> M 6D 1 <br /> .� <br /> Day <br /> e�$ Rslinqulshed By (Signature) Orgonlzotlon Date/Time Re Laborot Dy (Slgnatur.) Dots/ltme As C otod <br />