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413075453 ' ti <br /> CITATION CIRCUITS INC. 1950 WEST FREMONT STREVT <br /> 209-466-4000 STOCKTON, CA 95203 <br /> -asiiiliiaiiiiiiiiiiaiaatiiaiiiaaiaaiaiaiaiaiaaaaaaaaaaaaiaiiiaiiiiilii ai!!a p p <br /> PRE-TREATMENT PROGRAM - CUSTODY TAG <br /> Test Requirementst ( ) - pH (EPA 150. 1 ) . <br /> ( ) - Trace metals, Total (EPA 200.7 ) , <br /> ( ) - Cyanide, Total (EPA 9010) . <br /> ( ) - Total Toxic Organics. <br /> Others <br /> Sample Typal ( ) - Grab. <br /> ( ) - 24 Hours Composite. <br /> ( ) - City Split. <br /> ( ) - at Point of Discharge <br /> - Others <br /> Sample Collection Periods From. . . . .U: , , , , , , ,To. . . . . . . . . . . . . . . . . <br /> Sample Collection Timet (Date) . . . . <br /> (Time) . . . .1��. . . . . . . . <br /> Preserva;tiv• IAddeds ( j - Nitric Acid <br /> Sulfuric Acid BY ( I . . . . . . . . . . <br /> Dates .. . ., . ,. ,. <br /> ( ) - Sodium/Potassium Hydroxide <br /> - <br /> CONTAINER � <br /> Time Date <br /> _ <br /> ' LOT <br /> -------t �/L--------- �-----------n 2-3 = am (S n/ ai ure )NUMBERi <br /> : Relinqui d Sys ignature ) ; Time <br /> Date ive <br /> - , ------- -------�/�� / /�- 2_Z '- Y (�ignature ) <br /> Relin fished Sys (Signature) ; Time ; <br /> Data , Race d Bys (Signature ) <br /> --------- __ ' _______________ _ <br /> -------- -------------------- <br /> Relinquished Sys (Signature ) ; Time ; <br /> Date ; Received By : (Signature ) <br /> --------------------- -- ----- Y (Signature) <br /> ; <br /> Relinquished Sys (Signature) ; Time Date ; Received Sys Sa nature) <br /> -ililiaaif aiiitiiaiiiaiia�aiaaaaiiaiaiaaaaaaata aaaaaaaaaaaiaaaiiaaiaitiaiiii ai c <br /> In House WESTON Result <br /> Result Sample Not . . . . . . . . . . . . . <br /> PH <br /> Cu, total (mg/1 ) <br /> Pb, total (mg/1 ) <br /> -------------------------------- <br /> Other (mg/1 ) <br /> -------------------------------- <br />