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w.+nr►ur yr %OU*IVUV runiv1 t UU66 <br /> Aft Chevron Products Company ■ 145 S State Collejooulevard ■ Brea CA 92822-2292 COC of <br /> Chevron Site Chevron Consultant Secor <br /> nNALYSESREQUIRED <br /> Chevron Site Address Address- t Fspecla,Instructions <br /> a` Consultant Contact 51.0�l- ��,I�t„+.., � ❑ g <br /> Consultant Phone No �I L9 1-0900 ❑ChevronPM L.1� 1I+u Consultant Protect No 7 IyZ �-h,Jb �O <br /> Chevron PM Phone No �l ra" ��f- yc� Sampling Company Eta(L m ❑ Q <br /> ��? p 9 p Y <br /> Q o o 5c.,4- Ga�sl� <br /> Sampled By(Print) c c , 1 o M <br /> Q w ❑ cs ❑ 5ga1,II.�SG?Gor n,� <br /> Sampler Signature = Z < a <br /> Chevron Service Code ZZ02800Laboratory } k� "!25 ❑ C3z w U w We `��L-8(yl-a+ro <br /> ❑ Construction/Retail Job or �P � d N o <br /> ($)Sete Assessment and Remediation (SAR) Job Laboratory Address S .� ��p © Y <br /> J^' ❑ Cry F U <br /> Lab Contact _QA A, r„c u,. i u- o ❑ U <br /> NOTE• <br /> Lab Phone No _ 00— `3��I[ " m ~ a o d ii <br /> THIS IS A LEGAL DOCUMENT ALL FIELDS MUST cmn m mo 0 o r m <br /> BE FILLED OUT CORRECTL Y AND COMPLETELY �� a to N o o <br /> 00 (0 N <br /> n¢. a a a 4 4a. <br /> 4 <br /> w w w w w w w <br /> Sample sample Container #of Sampling Date/ Preservation Notes/Comments <br /> Description Matrix Tvpe Containers Time <br /> }-O <br /> -ol S <br /> -3—ot 11� <br /> Rel quished By Company Date/Time Re u+s To Co a y Date/Time Turnaround Time <br /> L) � �6� ��(� d t �j{31a� 24 Hours Standard <br /> Relinquished y Company Date/Time pulshe—d-- Campo I ffff Date/Time 48 hours <br /> Other <br /> C aN oo Sam le lute <br /> Relinquished By Company DatelTimeuish To Company ❑-,---me p Integrity (Check by lab) <br /> Intact On Ice <br /> Chevron COC Revision 2 April 10,2001 <br />