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Page--of <br /> I <br /> Chain of Custod eeor� on-site Timvsys Temp: a <br /> ..... bp Project Mame 4&,wrq S p <br /> Off-site Time: '1J Temp: v <br /> BP BMJ/GEM CO Portfolio: ,� 1 „s(se 'c14 C� Sky Conditions: -a/c.s— <br /> BP Laboratory Contract lumber: Meteorological Events: -� <br /> Date: Requested Due Date(mm/dd/yy)�¢y�i�idrit7D T'I�?” Wind Speed: Direction: <br /> Send To: BP/GEM Facility No.. �f f C <br /> onsultant/Contractor: "44. �M U , <br /> Lab Name: ,� BP/GEM Facility Address: ep � � �r+I1,, a es s: moo,- &4L(4- <br /> Lab Address: Aktor T$. Site ID No. c 0w--p A4V L 44- <br /> j I$® 9 Site Lat/Long: EDD: <br /> California Global ID##:7 onsultant/Contractor Project No.: V stex <br /> Lab PM: P/GEM PM Contact: a c� onsultant/Contractor Tele/Fax p <br /> Tele/Fax:[ ® "-- � ddress: Consultant/Contractor PM:;rAL �J <br /> Report Type&QC Level: voice to: Consultant/Contractor or BP/GEM (Circle one) <br /> BP/GEM Account No.: cle/Fax: P/GEM Work Release No: <br /> Lab Bottle Order No: Matrix I Preservativea Rets lysis <br /> Item v' y N Sample Point Lot/Long and <br /> No. Sample Description Time d Laboratory No. o a <br /> �o 4, P °O N o"no Q.N Comments <br /> 00�' p 6P, d <br /> 2 loo �„ 00 g h- 900 <br /> 3 9� 6 <br /> 4 ✓ V6 <br /> 5 <br /> d <br /> 7 L9 c( o )s 6 <br /> s 7g Vf <br /> Sampler's Name:A,16& Re ois6ed By 1 Atiiliation Dateince ccepted I dfiliaj4onDate ime <br /> SCAf <br /> ampler's Company: O� <br /> Shipment Date: 14 (to <br /> Shipment Method: Lm+M <br /> Shipment Tracking No: <br /> Special Instructions: <br /> Custody Seals In Place Yes 1? No Temperature Blank Yes No -)c Cooler Temperature on Receipt "F/C. Trip Blank Yes' No <br /> LABORATORY BP COC Rev.l 215102 <br />