COMPLIANCE INFO_2002-2006 - Laserfiche WebLink

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Date: - 0 - V Chain of Cu tody Record Project Namer`V(f�wA� BP BU/GEM CO Portfolio: 59 BP Laboratory Contract Number: Requested Due Date (mm/dd/yy) 1.114 U j ut p, 12~11-cq Page of On-site Time: c� � l � nes Temp: "(_ , P Off- site ;:Time: Temp: Sky Conditions: 7 7 7,Consultant/Contractor: Meteorological Events: Wind Spend: Direction: Send To:BP/GEM Facility No.: 7 7 7,Consultant/Contractor: M 77 Lab Name: c ' "A r, i BP/GEM Facility Address: 3 $ �.�� C /Z/ ✓:) ,� c, ' Address: i �? � L r iF ± .�� l 2 ' � DA DL Lab Address: P �,t,)7 a Site ID No. 03-7 Site Lat/Long: -mail EDD: AIC !.: J)/-- alifornia Global ID #: Consultant/Contractor Project No.: fl , Lab PM: A7_ F ITBP/GEM PM Contact: Consultarit/Contractor Tele/Fax: • ,av p=.•) Tele/Fax: /, - ) -;, 4 b 0 0Address:Consultant/Contractor PM: ;, , E Report Type & QC Level: Invoice to. Consultant/Contractor or /G (Circle o BP/GEM Account No.: Lab Bottle Order No: Matrix Tele/Fax: Laboratory No. a Z � Preservatives N x x x x � Aa 00 r` 7 Requested N 00 W P/GEM Work Release No: - Analysis Sample Point Lat/Long and _ ! Comments �"• • Item No. 1 Sample Description S - I — to Time wsc v� 3 y � ¢ 4 S 6 7 8 9 LL 10 - Sampler's Name: ��'y + El " `) Relh quished By / Affiliation Date[rime ccepted By /: Non Date ime Sampler's Company: t. 7 �, �n 1P Shipment Date:, - a Shipment Method: Shipment Tracking No: Special Instructions: 'Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt °F/C Trip Blank Yes No A ' B CP OC Rev.1 2/5/02