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Flti <br /> .Chain of Custody Record !S�D Oa-site Time: _0 Temp:bp <br /> Project Name , /1&0 22- z Off-site Time: C{'" Temp; <br /> BP BU/GEM CO Portfolio: .44 x,,+h�_/l,'rl'a�r�-�c!�, Sky conditions: <br /> - - i <br /> BP I.Rboratory Contract Number: Meteorological Events: <br /> Date: <br /> Requested Due Date(mm/dd/yy) sr �y�,qq--� Wed Speed: Direction: <br /> Send To: BP/GEM Facility No.: Consultant/Contractor: V_ <br /> Lab Name: BPIGEM Facility Address: 11017 k of L Address: ,Qn QrL— <br /> Lab Address: '' �, Site ID No. 5t1 y C4 <br /> 01"44—j 1-1111 ell ff47-1 Site L.at/L.ong: e-mail EDD: <br /> California Global ID 11: -17 pol 3g Consultant/Contractor Project No.: <br /> Lab PM: ,4L- •>'- BP/GEM PM Contact: �4-r1J (� Consultant/Contractor Tele/Fax <br /> Tele/Fax; -j - Q f/ - Address: Consultant/Contractor PM: <br /> Report Type&QC Level; I Invoice to: Consultant/Contrect or IIP/GEM (Circle one)- <br /> BP/GEM Account No.: Tele/Fax: BP/GEM Work Release No: <br /> Lab Bottle Order No: Matrix Preservatives Requested Analysis <br /> CrlValf/ <br /> Item �, N r le Roin a llAnz and <br /> lvu Sample Description Time Laboratory No. N Comments <br /> o o 00 <br /> 2 2 vv <br /> 3, W y <br /> { 6 <br /> }}F <br /> 8 <br /> 10 ' L") �2 <br /> 1 <br /> Sampler's Name: /11 t Rellnquhhed 4y/Amit tion Dare Time Accepted By I AMA.. Ute imo <br /> p <br /> let's Company: t)o bment Date: 3— rmentMethod: ,�ment Tracking o: ! ' t 47�1"Ve <br /> tial Instructions: <br /> y Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt °F Trip Blank YesNo <br /> LAB RA 0HY BP COC Rev.1 2/5/02 <br />