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• •Pagr—L of <br /> Chain of Custody record L� �= <br /> '4 wh ' On-site Time: ©3t Tenip: GD <br /> Project Naine <br /> s 'a Off-site Timeto Temp: <br /> Bt Ply/C iEM CO Portfolio: r 'c(c! Sky Conditions: �(4� <br /> M' Laboratory C onti'act Nuixiber: Meteorological Events:aQ— <br /> Date: ��� � Requested Due Date(mm/dd/yy) . FIp �74� Wind Speed; Direction: Amp- <br /> =' . <br /> BP/GEM Facility No.: rConsultant/Contractor: ��BP/GEM Facility Address: Q6 M "i Address:7 lr ( Site ID No.Site Latd-ong: <br /> e-mail EDD: <br /> L'~ Califomia Global ID#:-r-040770e/? Consultant/Contractor Project No.: <br /> Lab PM' • BP/GEM PM Contact: Consultant/Contractor Tele/Fax d 7l 6ao <br /> 7 ele/l`i <br /> 07 Address- <br /> Report 1'M: <br /> Report Type& QC Level: � Invoice to: Consultant/Contractor or P/ <br /> (Circle one) <br /> BP/Gl M Account No.: Fele/Fax; BP/GEM Work Release No: <br /> Lab Bottle Order No: Matrix Preservatives Requested Analysis <br /> G <br /> b q <br /> No. Sample Description Time ;d Q y Laboratory No, Sam o � No x � o � p g and <br /> 1C Point Lat/Lpn <br /> 00 0N0 Comments <br /> I C4 3V3 m <br /> LOD <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 1/L... <br /> O LER CUM DY SEALS INIAC <br /> 8 <br /> NOT INTACT <br /> 9 E12E o <br /> RATU <br /> C <br /> l0 <br /> Sampler's Ndn1C Retiuguithed By 1 Ati'diatiuu Date ime Accepted By/A a as Da6e } � <br /> Sampler's Company: S4L alL,-S <br /> !3 <br /> Shipment Date: 3 <br /> Shipment Method. <br /> Shipment Tracking No: <br /> Special Instructions: <br /> Instructions: <br /> Custody Seals In Place Yes 44t_-N0__L Temperature Blank Yes No CooIer Temperature on Receipt °F/C Trip Blank Yes No <br /> LABORATORY BP COC Rev.1 215/02 <br />