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� � � I• � � � � � i• � � I• � I•� t� <br /> to Analytical EXXON CONY, U.S.A. <br /> 680 Chesapeake Dr <br /> Redwood City,CA 94063 P 0 8ox 2180,Hauston,TX 77002-7426 <br /> (415)364 9600 FAX(415)364 9233 <br /> CHAIN OF CUSTODY <br /> Page of <br /> Consultant's Name eocjineeno !Q , 1 <br /> _ l Site Location <br /> Address tJ « l <br /> Protect# Consultant Project# S - <br /> Consultant Work Release# <br /> Laboratory Work Release# <br /> Protect Contact ` t Phone# a`�,- 'j 1 ry <br /> EXXON Contact Phone # i EXXON RAS # v <br /> lir s C <br /> Y <br /> Sampled by (print) 'l FC, t (] ���Z <br /> Sampler's Signature ��4 i „�; <br /> Shipment Method P[t�; u Air Bill # <br /> TIT ❑ 24 hr ❑ 48 hr 1:172 hr ❑ 96 hr *Standard (10 day) ANALYSIS REQUIRED <br /> CIX # Ol Sequoia's TPH/Gas TPH/ TRPH Temperature <br /> Collection Collection Mat BTEX/ Diesel S M <br /> SamplePrsv <br /> Date Time Soil/Water/Air Cont Sample# 5520 Inbound Seal Yes No <br /> DeSCfIP tl0n 8015/ EPA outbound Seal Yes No <br /> m <br /> 8020 8015 0 <br /> 4 � <br /> 1� } <br /> Poi <br /> lye�ti <br /> ,— T <br /> 14C.' 3 x <br /> c- <br /> JL[ IL <br /> 1 X a6 <br /> RELINQUISHED BY/AFFILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> l /' <br />