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S?MLL OIL COMPANY HAIN OF CUSTODY RECORD Date: Zlw-7f. <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No, 96OZ0 7 ` ZPage / of / <br /> Site Address. <br /> 3725 S. Tracy Blvd. , Tracy Analysis Required LAB: Nef <br /> WIC0. <br /> 204-7884-0901 CHECK ONE(1)lox ONLY MDT TURN AROUND TIME <br /> I <br /> Shell Engineer. Phone No ; 510 Ow Monllomg "At24noun ❑ <br /> Daniel Kirk 675-6168 sr.rnvrllCdbn ❑ 4ut AA hours ❑ <br /> Fax #: 679-6172 <br /> Consullant Name & Address: <br /> Blaine Tech Services, Inc. sovctoKW/Dl�pofol ❑ ��12 y } <br /> 16 days ►rlormap <br /> 985 Timothy Dr San Jose CA 95133 x Wolof <br /> Consultant Contact, p e Npp v w cto slly/D poral ❑ 4443 Olhor ❑ <br /> y 5 i 5 ( •• N °° <br /> 408 SoulAle R.m or Syr <br /> Fran Thie Fox — w N o a M ❑ us2 NOrE Notify Loa of <br /> Comments A Walls Rom.or Sys loOrl or►ofAhi.or <br /> Ou 03 a a M 4453 24/45 hrf fAr <br /> a 9 0 n Z Othor ❑ <br /> Sampled by. a <br /> gjjIJP y' VA -C A)Tl nj C 0 0 N e p 0 <br /> g co Co o o U) 0 UST AGENCY: <br /> N o <br /> Printed Name. ¢ a Uj d ° r o SAMPLE <br /> Sample ID Dale Bludvo Solt Water Ali No °f x MATERIL <br /> a o a o v o DE CRIPTION CONDITION/ <br /> costs m > U a U a U COMMENTS <br /> -IX I 115o x 5 x <br /> w '7-�} - <br /> w31� -- X - - - <br /> _ <br /> (}� X 3Lilmoi' Tune lnit a1 <br /> UP x -3 x <br /> No -_-- In 134s <br /> r <br /> inquls d B gn re) Pr r)ted Name pato Ra ve (sIQ lure) Pilnlod N e.� pal 6 <br /> o 4-t 11/ Iv� Time • _ .r' Brno. <br /> of h d tso(slpnalu e). I drite ania, R c fln fur ) Erto UNa <br /> Da a <br /> Till U- " m _) ::JTime <br /> R Hauls a By(slgnaturo), Prin ed Name Date R c e (s elute) Printed Noma Dale <br /> Time Time <br /> THUABORATO MULERQyIDEA Q21PY_OF TI IIS Cl{AlL[�QL2U1QPY WMLjNyQtCE A <br /> I� �� n.+Mrnnutuaar <br />