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DEC. 9.23e2 3:24PM CRJVR DTSC - HEMP NO.646 P.2/2 <br /> &panrhsnt of Tmdc Sututances Canna SUPPLEMENTAL <br /> Hazardotm Materials Laboratory tCt,.ek it e�0~,&w Requw4 <br /> AUTHORIZATION REQUEST FORM (ARF) <br /> PART A : (Hy Requestor-PLEASE PRINT) TAT Level : � [� <br /> (&Wk arra) `� 2 3 4 <br /> Requesters Name _L,G O (/,e/IC e -Z- _ Phone ( 3 K??S <br /> Region/Unit — ' ,'a v� T 1-5 15_Z,6 FAx ( s7z7 <br /> BACX-UP REQUESTOR _-- OA;s Y,,: -- a �.*.` Phone ( /o ) Q 3 6 3 <br /> SITE: r e, n je <br /> PART 8: Analytical Requests (By RegUestor) (Lab usem daaul metModx Ustrsd below,ALL airier requests piesac specify) <br /> Number of Samples/Type Number of 5amptea!fype <br /> Inorganic Anal sic sakd Liquid Water CtrA f Organic Analysis Saga Liquid Watar Ofner <br /> Metals Scan (60 IQ) CL-Pest (8081) <br /> Metals)Specitic: OP-Pest(B141) <br /> WET. PCBs 8082 <br /> pH G R 0 80138) <br /> C ar)Ides D R Q!lE otor CiE WAL 81 <br /> n-Hexane'Es3ractahies(IM4) <br /> Flash Point(I a20) <br /> TCL•P Analysis �• Q VOCs > aar�x (82sa) <br /> (see rocmates) seri"K n.cnuarv) [_o CLP tiv l SVC= (827D) <br /> Metals PAHs (8276) <br /> Mercu <br /> Volatiies c a.wo n) <br /> Sernivoiatlles .••,ftI-► <br /> (as yrs,..gists in4 <br /> 1060w,W[ita in) <br /> Analysis Objective: =Drk*lrtg thO Standards (upoiaL to OW o.siy) =Tmatment Sianxfards Im4ma+a s..i rmans <br /> (check ban) t/Waste cliarattertzwW =PRGs {cam Lb inw�V-owdeal <br /> Detection Limit Requirements: (must be shown on,SAR alga) <br /> isa+dk�tx�noaals4.utpaeviaors) <br /> 3 - • <br /> Expected Date of Sample,Arrival at Lab <br /> T�:E <br /> PART C: (Sy STO-HML) <br /> Authorization Number(AN) ARF's <br /> ttavmion No. <br /> Lab to Receive Sample(s) Name: Hazardous Materials Lab <br /> Address: 700 Heinz SC-51 Ste.---150 <br /> Berkeley, CA 947 f 0 �] <br /> Sample Tracking Officer(STO) ,�Y1 Check box ifCancelled <br /> Today`s Date; '_ d 1 Expiration Date <br /> TAT Lav*: *11- 10.15 drys(trqui va Lind chiefs Atgnatuts om SAP) 2■18.3fl days a- 31-45 duyc 4=whan pois;bie <br /> —rCLP- f f fkna poninio.andlw+ample matrix typo 4 appropriMe Lab may perform a TTLC at sa>.emV rasa on xh*sample(c)Lrrt xo dauwrmFna it TCLP is r>•adad. <br /> PAHit t)y 9310(LC),and STEX by paZ1 (cCralo)tray producer lx3v Cls forum*mairion.(Sao MW uaara manual tar GL mxrparisons) WSSR <br />