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ARL <br />A & R Laboratories <br />1401 Research Park Drive, Suite 100 <br />Riverside, CA 92507 <br />V1 951.779.0"0 • 800798.9336 F: 951.779.0344 <br />office(c)arlaboratorieS,C0M <br />RECEp/;:sn <br />ft,4- <br />MAY 2 2 2014 <br />ENVI110NMSV7A1. p < <br />DEPARTmE� .1"f <br />F172057-0�O�OO51 Chain of Custody Record <br />Page _Lof I <br />Tum Around <br />Analvs es Re uested arcle a ro date <br />Project No: Project Name: <br />B <br />� <br />m <br />NvagA <br />Q <br />m <br />a <br />Q 24hr RUSH' <br />0 48h RUSH' <br />ONormal <br />• <br />1205-00005 Unified Grociers, Stockton <br />Prof act Manager. Phone: <br />FAx: <br />Jennifer Ini uez 951-779 0310 <br />951.779-0344 <br />Cuatorner Name: (R.e.n. wo7 Street Address: m.wn —►aigl <br />A & R Laboratories 1401 Research Pk. Dr., Ste. 100 <br />eoae�.i. <br />addo al lee, work <br />rec "Waeef pn wit b* <br />P ..d Mal work day <br />Emaa: City, State Zip <br />ion nifer.iniouezLcDadaboratories.00m Riverside, <br />CA 92507 <br />Lab 4 Semple ID Grab! Date <br />nAb... vAr (A da uid .pP--r•pon) Comp sampled <br />Time Sample Container <br />sampled matrix • & Type <br />Specht inatrucUon. <br />Clarifier Grab 511/2112 <br />10:35 Water 2.%O.INDPE <br />X <br />Dates T1—:71 <br />RRIbgWarrd by: <br />M»: <br />TfrM: <br />DaN; <br />TNR.. <br />DISpOSdI <br />�T71 I U,1 2 <br />1) Rao by: OAe.: Ti—: <br />a) Reeve Dy: <br />b <br />TNR RAaaMd for Utwntory by: <br />Ties: <br />Q Return <br />Lab Disposal <br />rt Delivery Formats Wien other <br />TM sacee. o m be mrwktad by hbw.fay n.r- L01 <br />r- Samples Chilled Custody Seals Samples Intact emp C Dellvery aper ❑EMAIL ❑XLS arrangements are <br />.yes Q No Q Yes �fJo "'QNo C Q Courier Q Walk in DD, Type made w 16 da oe <br />^ O disposed ofso days <br />From Feld P UPS/Fed Ex DF, EPA Site ID erre eGCDt <br />.. <br />Laboratory Notes: Plea—Se CC: mart lu.escherOariaboratorle's-coo l <br />tan.ATORIFS COSMETICS <br />CHEMISTRY - MICROBIOLOGY • FOOD SAFE -CONSUMER Rulau— —1, -- <br />Vw d.lfmy.f..mphA.nd th. a*e M ON &18.hAln Of"~y brrn oaMtlluro..urh.rlt.don f. Rego nn Ut. Annfy. is .P.1hUd.b— -d., rh. T.nn. /red Co dW—. A.t Nnh on M. Get h --f. <br />Cary <br />YM C.Ry'A LRIrp Yial <.ry CRMI <br />Y:4b Gry MeI W (1tt..V-Iw .M�.al <br />