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❑ Yes <br /> Fax copy of Lab Report and COC to Chevron Contact: ❑ No Chain--Of—Custody—Record <br /> #9-625$ MR. BOB COCHRAN <br /> L�lerron Fae�igr Nlwlber Chevron Contact (Norm) <br /> Facility Address 2409 E. MAIN Q F ST. , STOCKTON, CA. (phone) 925)- 842- 9655 <br /> Chevron Products Co. SEQUOIA - <br /> P.O. BOX 6004 Consultant Pro)ed Nun*sr Laboratory Name <br /> Son Ramon, CA 94593 Consultant Name„ - - — t.aboratory Service order <br /> FAX (925)842-8370 <br /> Adds#e 6747 SIERRA COURTo SUITE J, DUBLIN, CA 94568 Laboratory Service Cods <br /> "&at Contact (N..)DEANNA L. HARDING Sompiss Collects by e) mom t'- <br /> (P <br /> (p )925-551-7555_(Fox Number) 925-551-7899 Signature <br /> State Method: CA ❑ OR ❑ WA ❑ NW Series ❑ ❑ UT IDAHO Remarks <br /> ., voce 5 Sud <br /> n <br /> _ e <br /> o +gin g o �� <br /> yQ N>< <br /> �t]pI Ub Sample No <br /> TBLB W HCL dk ` <br /> L"J <br /> NV <br /> �faD <br /> 1 <br /> b U <br /> RstygluBy (Signature) Organization Date/Time Received By (Signature) Orgonitation Dola/rime Iced Y/N Turn Mound Time (Circle Choice) <br /> //KKK' � c-R INC. <br /> 24 Hts <br /> RaEinqulshsd 4 (Signature) Organization Oats/Time Received By (Signature) 0r9an1zotlan Dale/Time Iced Y/N 48 tits v <br /> 5 Duye <br /> ` 10 Wye- <br /> Rallnquished B nature) Organization Dote/Time Recisved For �abwutwy 81f clove) Da e/lim• Iced T/N j Ca Mw <br /> Or ILI , r � , C 49 { <br />