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U res <br /> Fax , Co$0of Lab Report and COC to Chevron Co*ct- 0 No Chain--of—cusf --Record <br /> Ftrr� <br /> Chevron Fac111 Number 9--1918 Brett rlunter <br /> tY Chevron Conloct (Name)n U.S.A. Inc, Faofnty Addrese 49 r:. Harrlang WadSt"ockton, CA (phone) (510) 842-8695 <br /> Bax `5a0� Consultant Project Number �0I2 -3Z Laboratory Ngme Sequoia <br /> P. Consultant Nome Blaine TPC�I Services, Inc. LaboratoryRelease Number 2642370 <br /> San ItgrllaD, 42 Sd591 985 Timothy Dr. , San Jo%v, CA 95133 14w— <br /> Project Contact (Name) Jim Keller Colleotlon Data <br /> (phoneylOR 995—)S35 (Fax Numb•r)�Q � �-$7]3_ Slgnature <br /> Analye•e To Be Performed <br /> a s DO NOT BILL <br /> F �� �aA x � a g �` _'� o roR TB-LB <br /> V Bit <br /> n. N �`�$� pC�n q r� +Olg� qa <br /> E " Zw art 'aQi <br /> o �c$ 1Mti <br /> u a.� ��' 7 <br /> t. V\ Remarks <br /> 4,J f3/Z) - _ e-< X <br /> - 1 ifpop _ ?� �to✓t 4-t> �a2. <br /> rea <br /> 4 tq3n X <br /> o ftellnqulat+ed Dy (Signature) Organization Date/time Reoelved By (Signature) Organization Dale/Ttme Turn Around Time (Circle Choice) <br /> o q to 3c g �l Q�/o'3S <br /> 24 Hrv. <br /> Ra nqul■hed lay (S1 r•) Organizatlon Dote/,nrne Received Dy (Signature) Organization Dote/TTme 4a fire. <br /> 10 Days <br /> Anqutshed By (Signature) I Organization Date/Time 11•cleved For Laboratory By (Signature) Date/11 a ,qa Conlraotsd <br />