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CHAIN OF CUSTODY I ANALYSIS REQUEST <br /> Attention Mark Dysert Phone (650)799-9204 BIINna Of different) <br /> Company Name Dysert Environmental,Inc. Email environmenlal.data@gmail.com Attn:Accounts Payable <br /> Mailing Address P.O. Box 5608 Mobile Dysart Environmental,Inc. <br /> City,State&Zip San Mateo,CA 94402 P.O.No. 0262 P.D.Box 6608 <br /> Laboratory ANC C 371 IOS I Sampler/e aOW bool'-FY San Mateo,CA 94402 <br /> A <br /> Protect <br /> Pactiv Packaging In IncProtect Pactiv Packaging, Inc. sampling Cad.= LL <br /> I� <br /> 1110 PeKormance Drive 1110 Performance Drive Eat <br /> Name Stockton, CA 95206 Location Stockton,CA 95206 <br /> Sample Matrix= Field Notes: <br /> Wastewater 7 To TES <br /> Turn Around 24 DRvAS f <br /> Time=5 Day too,wL. Fkan ea6H <br /> Sample ID: Date: Time: No.of <br /> Containers <br /> I Ink Wash Water 1315 i.rwiv nP' x x <br /> a.nn.•nn.eW aw•maW nm. w�a <br /> RR ma, IS I /I Additional Melling Instructions; <br /> wnnsw.n.aW wex..a.r <br /> ne.nwm.eW k4 H axwr.euv nm. a.0 cc: <br /> 2—I <br /> mi.nwweaW arcnna.r V. w.. <br /> Lob Notes: <br /> Notes: <br /> On Site Contact:Mark Ross <br /> Analyze STLC Extract/or STLC Copper(Cu)If Cu is>26 Call#:209-268-11178(primary) <br /> Sample Temperature Upon Receipt In Lab= 3•113•I"L ORlee#:209.983.1473 <br /> ON Site Contact:Craig Retabach,Noble Environmental Services Corporation <br /> Dysert Environmental, Inc. Tel:(650) 799-9204 10 Enterprise OrNo,Carbondale,PA 18407 <br /> c' 670) 870)510-0816#2764 Web:DYsertEnvironmental.corn Preltzba bi.environental. <br /> com <br /> C37651: Chain of Custody <br /> Page 1 of 2 <br /> Erg 8of19 <br /> E ACCIJTEST. <br />