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LL OIL COMPANY WAIN OF CUSTODY RECORD Dale:RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No: Page 5 of ^J <br /> Site Address: 4Z0 W. '�Gman Lod-(* Analysis Required LAB: • �o� ar <br /> Uj <br /> fu�..�. - : L 3 5Q�-5 CHECK ONt(1)10XONtY CTIDI TURII A4a1lND TIME <br /> Y I7Git+rr`41�[ �s GLr? rti"dK" 9S g al�S Z.S �.. a W Monlomo ❑ 14i1 ❑ <br /> 1 21 houu <br /> Shell Engineer: Phone No.: 4 511 t,Inrniloalbn ❑ .441 48bouID <br /> n <br /> rlvtiLttf� Fax �f: us-�s�s W <br /> 0 Son Clouny/Dbpoeol ❑ 144! <br /> Consullanl Name & Address: a- Isaarr ❑uio�man <br /> CA*Ae%tIA FNVrf t4MRP1TA•L— "T�"GNtVCr-06t`ra loc— "° Q Wooer <br /> CA �+ ClatellylDiepoeat ❑ R147 01har ❑ <br /> Cansullcrnl Gonlacl. Phone Na•: 00 ton/Alt Rom or Sys ❑ 4452 <br /> (-?*I)99S Ri859 #A to d3 � 0 A M 1101[fI rloltly lob at <br /> 1q u5KC-Y COOL- Fax #:I-W)m-ups 0 -< V wal.r Rom or syr ❑ 14S] soon at lostlblo of <br /> N d O a M xeMa hu 1AT. <br /> Comments: v o to W <br /> U p V n. W Z s Other ❑ <br /> Sampled by: <br /> o c o, a, a m c UST AGENCY: <br /> r <br /> i a a 0 Q c 0 "o SAMPLE <br /> Printed Name: �• a1 0 a n a MATERIAL. <br /> y LU a E CONDITION/ <br /> Ti>U.e. <br /> 140 of = = w o 0 4 0 U DESCRIPTION COMMENTS <br /> Sample ID Dale 8IUdWQ 5011 wafer Ali conk r m > ,_ U <br /> - . o 1215 <br /> f <br /> 5 <br /> B 3 So S ► — — <br /> � — <br /> -Ss — <br /> s� � ib+5 <br /> Ian � <br /> _ x <br /> raze — <br /> �o� � �0l✓D <br /> SSB-� �•� — <br /> 255, 1d3� — H0�-D <br /> s8-4 - 30 �� 1 o9� <br /> Recely d(slg re): PtlrT,fe NarTle: <br /> T—E—L— <br /> Rei quls ed By(slgnalure): (} PrIrT d arae• Dale: 2-4 <br /> ek �� 1! a: 13o Ptb d Name• Da e• <br /> Relln y g ure). Prinled Nam Dale:z -� Re led nolur©): dtfK,4f— Time: 2t7 <br /> � 041 71me: rk,z� <br /> Data: Re a ved slgnafure); Pr nled Narn . Dale: <br /> Rellnqulshed 9y(slgnalWe): led Name: llmo: <br /> Tlrne <br /> met A nnDAT114Y MINT PROVIDE A COPY OF 11115 N - UO huaonsrwroor <br /> 1 <br />