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Paae of <br /> Chain of CUStociv RelOn-site Time 1200 Tem 6910/" <br /> 1, Project Name 11191 GV4'MonitoringOff-site lime 1s-T-0 Tem 93 <br /> D til' 13UCEM CO Portfolio- 'Retail Sk Conditions CAw_ <br /> 131' tsihoiatory Contiact Ntiniher' Atlantic Rtchfield Co Mcteorolo tcdl Events <br /> I <br /> ate 7 r/ay Requested Dae Date(imiudd/yy) /0 c4W Word S ped Dtrcctton <br /> Send To BPIGEM Facility No 11 l91 ConsultanllContractor URS <br /> Lab Name SEQUOIA BMEM Facility Address 1469 E HAMMER LANE, STOCKTON, CA Address 2870 Gateway Oaks Dr , Ste 300 <br /> Lab Address 1455 N McDowell Blvd Suite D Site 1D No 11191 Sacramento, CA 95833 <br /> Petaluma CA 94954 Site Lat/Lon -mail EDD denise ee ursco com <br /> alifomia Global ID# T0607700333 ConsultandContractorProtect No <br /> Lab PM An elee CanBP/GEM PM Contact PAUL SUPPLE Consultant Tele/Fax 916-679-23871916-679-2904 <br /> Tele/Fax 707-792-18651707-792-0342 Address P 0 Box 6549 Consuitant/Contractor PM VERN E <br /> i <br /> RLort f e&QC Level Send EDF Reports Mora a,CA 94570 Pwlce to Con sultant(Contractor BP/GEM ircleone} <br /> BP'GEM Account No 400-6-21124 rele/Fax 925-299-88911925-299-8872 PPiGENI Work Release No <br /> Lab Bottle Order No Matrix Preservatives Requested Anal}sis <br /> pj N72 <br /> F O <br /> wx g- r14 Sample Point Lat/Long and <br /> Item No Sample Description Time "El Laboratory No o N ¢ ¢ o <br /> m ¢ N Comments <br /> I L.i V <br /> cr3 z r Ao <br /> 1 -1 rYzz <br /> X1 I AbIDA-6 61 X X <br /> 2 > '2 ,s X X Ix <br /> 3 —63 <br /> 1 4 A w• se <br /> — <br /> 5 /Y0'&r SC aI.S XNT Cf <br /> 6 mw•6 / 1.8 x <br /> •7 rr37 <br /> LJ I9 <br /> 10 �/ <br /> tarn ler's Narnew6-, Qtr RchnquLWd B / itratioit YLITIC ted By I Affiliation Date ime <br /> tam leer's Cam an , ;2 61V <br /> A <br /> 5hl meat Date <br /> ,hi ment Method r' <br /> ,hi meat Tracking No <br /> ,oecial Instructions Address Invoice to BP/GEM but send to URS for approval -If total lead value is>50 analyze for lead by STLC value is>5 analvze for lead by TCLP <br /> RUN $260 ANALYTES IN ONE BATCH ANALYSTS <br /> :ustody Seals In Place Yes No Temperature Blastic Yes No Cooler Temperature on Receipt oFIC Trip Blank Yes No <br /> Distribution 'A kite Cop} -Laboratory/Ydlo�ti Copy HIGEIU /Purl.Copy-ConsultantlCon(rdctor BP COC Rev 1 21',tt1I <br />