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EXXON Com <br /> O NY, U S.A. <br /> I' 0 Box 4415, Ilotwon, I X 77210-4415 `} <br /> I N C O R P 0 R A T E P cixea CHAIN 01, CUS,I'ODY �ZI <br /> INI assaRANct Of QUAWr ❑ Novato CA, ll Digital Drive 94949 ❑ Hunungton1UH-11, CA, 5702 Bok,t Aventtc, 92649 <br /> (415) 883-6100 i (714) 892-2565 <br /> � g <br /> Consultant's Natnt, u <br /> Addrtss S11L LuLM1011 <br /> Pru LU b 3 2 !p Q Con+ult.tltl Proll-LI # Consultant Work Rdt ase,N <br /> Pro cu Contact n Plwn- a Fax N Laboratory Work RdLast# 'J <br /> EXXON Contact �� EE ❑ C&M Phultc. N Fax N EXXON RAS # Z. 1 <br /> Sam liA by (print) Sa111)lir s St gnaturL <br /> Shl{ttnc.nt MI-thodAtr (3111 b Sltq}1nLm DAL <br /> ANALYSIS REQUIRED SatnplL Conditionas RLLL&vtd <br /> TAT ❑ 24 hr ❑ 48 hr ❑ 72 hr Stand Ird (5 day) Tc npLraturL" C <br /> Cooler N <br /> o o Inbound Stial Yes Na <br /> ao 00 Oulboulld SL.11 Yes No <br /> 00 <br /> Sample DesLnption Collection Malnx Prow p of PACE C7 00 � GO � <br /> Uate lithe soiltwater Com 'wilyk 11 d x d a Q COMMENTS <br /> CL a. CL. a. a: a. <br /> 676,Lc <br /> 73 <br /> L 61 <br /> Rr-hnqutshrrd hylAfl'thanun Date T1111L Acl.c.plc.d bylAftillatcon Date Tltltl. Additional Cuulme.nls <br /> i <br /> i)Islnhuliuo Whdt, Ongmil link- LA) Goldenrod Coasultattl l«ld Strll <br />