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WORLD �I L DeMennv/I[erdoon dna World Oil Recycling 0 <br /> "Recycling for o[leaner Environment" Ch azn Of Cus tO dy <br /> RECYCLING,. 2000 North Alameda Street,Compton,CA 90222 Date r7J0 1 �2-t7 <br /> Ph(310)537-7100 Fax(310)639-1254 _Page I ofd_ <br /> (A DHS EIAPCerWcate#2037 <br /> Client: DELTA TRUCK SERVICE DEL040 Contact: STAN SHAW Tel: 209-983-2400 Fax: ~� <br /> Address: 10182 S. HARLAN City: FRENCH CAMP State: CA Zip Code: 95231 <br /> Project Name: D11- Sampler(s)Signature: ' <br /> Project Manager: Approved By: <br /> Due Date ❑ Regular Rush z Days Comments: <br /> Lab Date Time No. of <br /> Sample Description ID Collected Matrix Containers Analysis Requested <br /> OILY SLUDGE � - I ��`�•Zn gw�pA� LIQUID 1 TPH as gasoline, diesel, and motor oil <br /> CAM 17 METALS <br /> BTEX <br /> ACCOUNT: DEL040 <br /> CAR000077909 <br /> V - L <br /> Sample Conditions: Seal Intact ❑ Broken ❑ None; Temperature ❑ Cold [� Room; Other <br /> Relinquished by (signature) Received by (Signature) Date/Time=`:%- it 4,, <br /> Relinquished by (signature) Received by (signature) 4 Date/Time El . ' <br /> Relinquished by (signature) Received by (Signature) Date/Time <br /> SPECIAL INSTRUCTIONS <br />