Laserfiche WebLink
mom to Mw **�■ <br /> EXAM COMPANY, USA. (West Coast) CHAIN OF CUSTODY RECORD NO Page of <br /> Exxon Engineer Phone ANALYSIS REQUEST OTHER <br /> ,��^ (CHECK APPROPRIATE= BOX) <br /> Consultant Co Name ,�y ,�,,,`A 0"61L Contacty t .e1.�_ _r - <br /> Address Mr`"t[G�`� wT Fax �-�1 -(�� r r_}__[� - - ❑ ❑ ❑ ❑ ❑ ❑ <br /> n �C3 L) i <br /> RAS# - J~'�y'1r Facility/State ID#(TN Only} _-- --- -- ^.,. a ❑ m a <br /> 13 <br /> Cosu+ nProject#AFE#(Terminal Only) ❑ w ❑ o <br /> 1 f o s <br /> Location "T I�. City) SMOG nm (State) CA � 1�( � p � E3 <br /> 13 � a 9 <br /> CD <br /> EE ❑ CBM ❑ SRT Of n o o <br /> /t x N 'Q m p °0 1 <br /> p 1 ri W z ❑ <br /> Consultant Work Release# 4 t{� i[D ra m �( N w o <br /> ddii 1 — z s m 0 LU N �' p ai o ¢ o [] m <br /> Sampled By —1rL1 _� � - " z N N �, a <br /> i, Q v tt > a w i o w tt p <br /> SAMPLE I D DATE TIME COMP GRAB MATRIX OTHER Fw_cHmm po z a � ,� x m o w z � LU � � -D d Q <br /> '}� i O SOIL AIR z c) f m 2 o o > a a a <br /> } a <br /> /t <br /> NI —(0 l� t�,00 X 3 K X <br /> elJitloo 14ho X G31 X X K <br /> N1 VJ - 11lob 13io X G 3 x X X <br /> Dl� 91111M 1;5zo 3 X )<, X <br /> NAV1 - Iz— 1 111 0013)v X X iC <br /> M V\J qlit6 ty+7- x G 5 X X X <br /> Y, 3 X ' K, X <br /> x X <br /> TAT SPECIAL DETECTION LIMITS (Specify) REMARKS <br /> 24 HR * 72 HR <br /> 48 HR �` 96 HR Y' EXXON UST <br /> 3 Business Contact US Prior CONTRACT NO SPECIAL REPORTING REQUIREMENTS (Specify) LAB USE ONLY Lot# Storage Location <br /> to Sending Sample C41483 <br /> 7thes PDF © © EDD <br /> QAIQC Level <br /> 'taadard _ CCP 0 other Cl FAX ❑ FAX C-O-C VV/REPORT WORK ORDER# f L?t-� LAB WORK RELEASE# <br /> Relinquished By am er Date Time Received By <br /> I W001V <br /> USI DY Retiriquished bate Time Received By <br /> RECORD <br /> Reltnqutshed ate , Time Ref w d B � <br /> a T _ <br /> licate Ouginal •White Labs Copy •Green <br />