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SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Date: <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No: Page of <br /> Site Address:34l 4�-'45I q Analysis Required LAB: S- <br /> rQudlA AgA._YT)GAL_ <br /> WIC#: 2 0 `\� CHECK ONE(1)!OX ONLY CT/DT TURN AROUND TIME <br /> y ��� L � vr <br /> Shell Engineer: Phone No.: G.W. Monflorinp F) "6124houn C <br /> —' She Investigation u11 <br /> -�t �N G R.2 Fax #: O 7 IE houn <br /> Consultant Name &Address: t144 &sit-St, &'i4e � S (� Soil Classify/Disposal ❑ Al/2 <br /> _ Co 16 days C1(N01m3ll <br /> CAM 2ffi EtovlRotJM_t�,Z L 1 ^ X o wMat ❑ <br /> ^ w Classify/Disposal '"3 ❑ <br /> Consultant Contact: Phone No.: o rJ other <br /> SIO- q2-o-O7O v - ,� A od in Soli/Alt Rem or Sys, "S2 <br /> r O&M ElMA C-L- _ p Fax#: 2 O-c/ i Q O Q Q ,n NOTE: Notify Lob as <br /> Comments' n Water Ram.or Sys. 60011 no Possible of <br /> Tj N W O 6 M ❑ ddSJ 24/AS hrs. TAT.10 x <br /> l <br /> 2 2 Cs C Ty a_ d Z Other ❑ <br /> Sampled by:�N 1��p T G L T7�NS g O o c J N >_ <br /> Co co a o` " " o UST AGENCY: <br /> Printed Name: a s W 0 o a o c_ o SAMPLE <br /> ;Im- `" ° E N I— ar ° °a E MATERIAL <br /> Sample ID Date -Sludge Soil Water Air No.of x o 0 0 o ar o DESCRIPTION CONDITION/ <br /> conts. m > U �` Q U L U COMMENTS <br /> S-2 1(&6) ( HOLD ) <br /> Wito x I C�IOLO 04 <br /> S-2 (C)F.a )v i b Y, I X X X 6041807 <br /> S-LI (1.0) ��' 3o x I Cl-IOLL� <br /> 5-q H.5) 1/.'30 X 1 >< X X 6041808 <br /> S - 5 5.0 1/;3� X I x x K 6041809 <br /> S- 3 (4.5 6041810 <br /> wish tTu�� Prlprd ame:— `i r Date: ec d signature Printed ame: Date: <br /> lI ! l t; f me: �-1Zi e• <br /> Reil rBy(sign tire): Prin ed Vbaw Date Recelve signature): Printed Name: Date: <br /> 0 Time: 010 Time: <br /> Rellnqulshed By(signahxe): Printed Name: Date: Re (sig — - Printed ame: Date: <br /> Time: s G Time: <br /> THE LABORAIM MUST PROVIDE A COPY OF Ttll" ME AND RESULTS <br /> sw a o,er curoa, <br /> r <br />