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�r <br /> Chesapeake Dr 7UW <br /> / 7 <br /> woRedwood City,CA 94063 PIJ Box 2180,HTX 77002-7426 ` <br /> (415)364 9600 • FAX(415} 64-9233 CHAIN 0 F CUSTODY <br /> Consultant's Name Page of L <br /> Address Site Location <br /> Project# Consultant Proje t Consultant Work Release <br /> Project Contac Phone # d Z Q Laboratory Work Release# <br /> m <br /> EXXON Contact Phone# EXXON RAS# <br /> Sampled by(print) �_ Sampler's Signature. C: <br /> Shipment Method J Air Bill # a <br /> TAT ❑ 24 hr ❑ 48 hr teh! ❑ 96 hr ndard (10 day) ANALYSIS REQUIRED <br /> Sample Collection Collection Matrix # of Sequoia's TPWGas TPW TRPH Tompara,ura <br /> Prsv BTEXI Diesel S M <br /> Description Date Time Soil/WaterlAir Cont Sample# BT EPA 5520 Inbound sant Yos No <br /> Outbound Saul Yas hu N <br /> 8020 8015 j <br /> Crz <br /> _ 'X <br /> Imp <br /> 0 <br /> �- <br /> v� <br /> L/ 0 <br /> 0 <br /> Cr <br /> _J X — <br /> ;2. 1 �3 <br /> PP <br /> RELI ED BY/AFFILIATION D Time ACCEPTED/AFFILIATION Date Time AddiflonnlCommenis <br />