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r. <br /> a< . Chain of Custody Record Lr��-- on-site Time: 0Ll Jemp:, q0 <br /> bp Project Name off site Tune: 9 kS Temp; r <br /> BP BU/GEM CO Portfolio: �,Gn�a� Sky Conditions: J4 <br /> j; <br /> BP Laboratory Contract Nuniber: Meteorological Events: 1QY <br /> Date: ' C7 Requested Due Date(mm/dd/yy) �i6�,�Q,a[S> kyr-- Wind Speed: 'Direction: <br /> i� <br /> Send To: P/GBMFacilityNo.: a,L._p Consultant/Cointractor:- F-- U, <br /> Lab Name: EPIGEM Facility Address: t Address: 011 - <br /> Lab Address: 7C_ Site ID No. c G <br /> r fv1 ,/ fJ Sile Lat/iang: a-mail EDD: <br /> allfornia Global ID/1: by 77W 3 Consultant/Contractor Project Nb.: <br /> Lab PM: L ,r BP/GEM PM Contact: oosuitant/Contfactor Tele/Fa t 6 <br /> Tele/Fax40 Ld/ey) -(� ddress; Consultant/Contractor PM: <br /> Report Type&QC Level: t invoice to: Consultant/Cofliract or BP/GEM (Circle one) <br /> BP/GEM Account No.: ele/llax: JBP1GEM World Release No;' <br /> Lab Bottle Order No: Matrix Preservatives Requested Analysis. <br /> Itemy Sample Point Lat/Long and <br /> No. Sample Description Time q Laboratory No, 00 r4 ronren <br /> a14 zCn <br /> x x M R N �� .00 <br /> 1 w . <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> H76 <br /> 8 <br /> 9. <br /> 10 <br /> Sampler's Name: 11-"L.6 Rolingttishi:4 By/ fRi6tion Ditto Irime iAccoptod By A ation Date Ime <br /> Sam leA Company: ii±ow4s &,A, <br /> i <br /> Shipment Date: C 3 �s <br /> Shipment Method: ' <br /> Shipment Tracking No: <br /> ,pecial Instructions: <br /> i <br /> dy Seals 16 Place Yes o Temperature Blank Yes No L--Cooler Temperature on Receipt_�t2l UC Trip Blank Yes No <br /> 1 BP COC R <br /> LARAOR ev.1 2l4R12 <br /> a <br /> l <br />