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padwbac <br /> '2 ` Chaffin ®f CustodyPecord On-site Time: <br /> Temp- <br /> Project <br /> i <br /> Project Name y��' sRL g%' Off-site Time: Temp: 1 <br /> bp <br /> BP BU/GENT CO Portfolio: ft'4 ac sky Conditions: 1 <br /> BP Laboratory Contract Number: Meteorological Events: <br /> Date: Requested Due Date(mm/ddlyy) �` Wind Speed: Direction: <br /> I <br /> Send To: P/GEM Facility No.: G Consultant/Contractor: o r <br /> Lab Name: ,�eg v /.wBP/GEM Facility Address: 40o� p JAV $ ddress: 33 A rpt <br /> Lab Address: r Rh / Site ID No. w wvate. nkp <br /> a�— Site Lat/t ong: -mail EDD-40-71.— 91- 6 s JYs <br /> California Global ID#: Consultant/Contractor Project No.: (�Ff <br /> Lab PM: vir, Ara° BP/GEM PM Contact: y Consultant/Contractor Tele/Fax: 71/"4of <br /> Tele/Fax: �fli ddress: �! Consultant/Contractor PM: <br /> Report Type&QC Level; M pp r otsjj, H 570 Invoice to: Consultant/Contractor or AFGart(Circle one) <br /> BI'/GEM Account No.: Tele/Fax: BP/GEM Work Release No: <br /> Lab Bottle Order No: Matrix Preservatives Requested Analysis <br /> v ` <br /> Item � �, � Sample Paint Lai/Long and <br /> Sample Description Time :n Q «. Laboratory o <br /> No, o <br /> h No. o w Q °a N N &I a t a Comments <br /> oo ao N \ <br /> ron vs Q V z x <br /> 2 to, —Z 17 1L f 42— n I 14� n <br /> 3 m4 P. <br /> 4 F/*Ylc 4"y- <br /> 5 r y"'� SZ t'1 in 5 <br /> 7 M14 NMI Ohm ilk 3 <br /> s eo <br /> fz <br /> 1 D AIAV°A7 �- <br /> Sampler's Name: 0( / AV <br /> tMUZSM <br /> aliatlon Date Time ceepted By 1 float Date rimc <br /> Sampler's Company: L R. a3 11_. tk°C <br /> Shipment Date: �O <br /> Shipment Method: <br /> Shipment Tracking No: <br /> Special Instructions: l veya t e n!4 - k <br /> Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt l<gVFIC. Trip Blank Yes No <br /> LABORATORY SP COC Rev.1 215!62 <br />