Laserfiche WebLink
aS'-a�-t2ti-r��Z <br /> Chain of Custody Record Nge- LOf .� <br /> bp Project Name- BP 11194 ON F Qumterly0"tte Time- 0 TemP $ <br /> BP HU/ARRegion/EnfosSegm nt: BP>Amer:res>westCmt>ReW>WMU>CA Off-site Time Tenm 67 <br /> >Cmkd>tttsa>FSsbwWBt lryCondmtms ri14, <br /> State or Lead Regulatory Agen y. San Jrraqum Cm*EnA me W Mmage wt Dept. cal Everas 6/M;e, <br /> Requested Dn Date(mm/dd/yy): rY,/ and S /j P A DuvcUm S 45' <br /> NM >a P/AR No• 11194 onsultmt/Coniractor URS <br /> ddreas 1435 N McDowell Blvd Suite D IAR}?a iii Addmw 2375 Blvd, CA 95376 ddress 2870 GatewayOaks Driv Suite 300 <br /> Petatinrm,CA 94934 ite N/A Sacramento CA 95833 <br /> PM-Robert Buder ahft8rnta obel ID Nm T060770001I oosoltaitt/ConuxctarPro edNo. 38466553 <br /> ax 707 79218651707 7910342 fos Prof No 0307 WZ-0011 CC MraMr PM. IefBny Brooke <br /> IAR PM Contact Pahl S le tet RCOP• Provision oldFax. 916 679 2383/916.679.2900 <br /> P 0 Box 6549 04-Mon/ltamcd NduW Attenuation dt QC LeveL Levr11 with mp <br /> M CA 94570 b asic 03- cal EDD To l3erusa X trout <br /> eleN=925.299 8891/925.299 8672 Cost Elam 05-Subcontracted Costs oe ur Altattttc litchUd Co <br /> Lab Bottle Order Pio: Matra Preservative Requested Analpats <br /> 1� Sample Description A Laboratory No F ple 1'omv g and Com ti <br /> � o <br /> 10014 OR <br /> 1 M W- N Mo y-7y tit 6 x X x x <br /> 2 M W-� ►3po tv 6 <br /> 3 Ih W" �? IZI "3 12 <br /> a {2K <br /> 5 O*r.bt �rn&v—S I cob <br /> 6 /� I Ui —�j 1 3S a 4 <br /> 7 1_U04UZV9r- " — b On �1w <br /> 8 <br /> I � <br /> i0 <br /> Sampler's Name v Rclm uisbWVp1AffttMi3 Date Time ted / faIatt= Date Ttma <br /> stn let's Coat an ,• ID <br /> hi anent Date �ZZ <br /> Shipment Method <br /> IShipment TmckLag No, <br /> redal Instracum. <br /> ustody Seals 1n Place Yes No Teg Blank Yes No Cooler Temperature m Recetp "-� oP/C Tvie Blank Yes X No <br /> Distribution White Co"-Laboratory/Yellow Copy-13P/Atlantic Itchfield Co /Pink Copy-Consultant/Contractor BP COC Rev 4 10n/04 <br />