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LAB(LOCATION) 4 Shell Oil Products Chain Of Custody Record <br /> :::---::please Gheck.A iu lafe Bozi: ;: print Bill To:CLintact Name::-.2 -: JNCIDENT#(EWSER4IDES): El amc IF NO INCIDENT aA LIES <br /> Q SPL( , .. - <br /> ❑ENV.SERVICE Q MOINA RETAIL ❑SHELL 0.ETAIL AubreyCool-241729 3 D D 0 0 2 DATE: 3 o <br /> ❑XEN O <br /> ❑T6TAMERIG ( 1 Q MOIMA 5D6CM +Q CONSULTAM ❑LUBES : pp - SAR# :.:.: <br /> Q QTHg(( I ❑SHELL PIPELINE Q OrHEE PAGE: 01 <br /> e.WPrme ccw,xv: moa. BITE ADDRESS:Sial and airy SYIe ov,tio xa- <br /> Blaine Tech Services 3515 Navy Drive,Stockton CA T0607700176 <br /> AooaEse. 3.1.1m.e.e TO I.—c°,�-are,.s�1. xe xo- N� rmr.N+PeoedTx <br /> Iwo Rogers Avenue,San Jose,CA 95112 An Pxn sh - cox <br /> a."�*�*"°ir"^°^n^"^""R^•r Anni Kreml 510d2oJ335 shellenf cravmnd.com snow 9430�Ll <br /> David Webb-Copy Shell.Lab.Billing@cmwodd.com <br /> Mun'.0d, ` <br /> 916-925-2913 ext 102 916-925-2891 r dwebboblainelech.mm <br /> TURNAROUND WE(CALENDAR DAY6): ❑RESULTS NEEDED <br /> STANDARD(11 my) ❑5DAYS Q3DAYS ❑2DAYS ❑21 HWRS ON WEEKENO REQUESTED ANALYSIS <br /> ❑ G-RWQ®aHYWT FORMAT ❑ USr AGENCY: <br /> TEMPERATURE ON RECEIPT <br /> ❑SHELL CONTR RATE APPUES O° <br /> SPECIAL INSTRUCTIONS OR NOTES; m <br /> ❑$TATE RDMBURSEMENF RATE APPDFS <br /> N O m <br /> Celedlm Mrl9s must 4 at kart TPHG.77i4-D.ENNw1=50ppD,MelDand1'100PPD ❑EDD NOT NEEOFD m _ <br /> Q+ RIDUFT VOUFKATION REQUESTED <br /> BMX.MIKE,DD.E.ETRE.TAME=.Sppb XYbN'SPD.e "md bed=10uppb IS m 0 p o 0 0 J <br /> SAMPLING PRESEEVAnvE n c ne r <br /> Field Sample Identification No.OF = m w m ry <br /> m `- e a m o °_ > <br /> MArwX co Nr. x x : W w W W o e o a° ContainerE D Readings <br /> DATE TIME x w m m ¢ 0 m0 m d 2 or Laboratory Notes <br /> HN03145C1 NONE OWER ~ f m N F F O <br /> MW-ZZ g31 ,6 IA) 1C 5 XXX X <br /> 3 8 gO 1440 1 1 & X X <br /> s3 Mw/-Z4 8 1 IIaS x <br /> X1 17 xXXXX X <br /> M -ZS 1( X <br /> 33 <br /> AW- g 30 n )C <br /> +' 8A0 1345 X X 1S <br /> Mw-?-CA ,,a X X K X X X <br /> r1W-ja 31 1330 X S X X X <br /> MW-31 S 1vx 1C 5 n <br /> 0. W 3z 3A 141s X x S X X <br /> R�^KYne1 q;( unl ge[ervedM tSlpnelurel wr¢ nme <br /> q Nr flecwgpy: Tal / Dna Tmv <br /> rxp :(sgneum) I Raurad b/'(aid,uWnl ONe nmr. <br /> Com- <br /> - bYlAd Rni.ien M <br /> J <br /> W <br />