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TestAmerica West Sacramento <br />880 Riverside Parkway Chain of Custody Record TestAmedca <br />West Sacramento, CA 95605 <br />Phone (9161373.5600 <br />Sampler <br />Lab PM <br />Carper Tracking No(t1 <br />COC No <br />Client Information <br />Brian Branscum <br />Wagner, Heather <br />Client Corlaci <br />Amps <br />E -Med <br />Page <br />Amanda Magee <br />916 281-8361 <br />heather wag ner testamerlcalnc.cbm <br />Pae of <br />Company <br />Jcc s <br />Stantec Consulting Services Inc <br />Anal sle Rec uested <br />Address <br />Due Date Requested: <br />Preservation Codes: <br />3875 Atherton Road <br />a <br />A - HCL M - Hexane <br />Cay <br />TAT Requested (days): <br />Rockl n24 <br />H R <br />a <br />u+ <br />5- Nii N- None <br />C - Zn Acetate O - ASNaG2 <br />D - N,L-C AC;O P - Na204S <br />Stell Z:D <br />CA. 95765 <br />= <br />< <br />E - NeHSO4 0 - Ne2SO3 <br />F - M90H R - Ne2S2S03 <br />Phons <br />POs <br />(916) 472-3985 <br />`- <br />ui <br />mm <br />G - Amchior S - H2SO4 <br />H - AscorDc Acid T • TSP Dodecehydrate <br />I -iceU - Acetone <br />EmeJ <br />W0230335 <br />„ <br />� <br />`p <br />a <br />e <br />< <br />p� <br />m <br />g <br />F <br />C <br />J - DI Water V - MC.AA <br />K - EDTA W - ph 4-5 <br />PfOieCl Name <br />Prb;eCt M <br />Stantec-CA-non-ENFOS <br />o <br />>$ <br />o <br />W <br />c <br />u <br />L • EDA Z - otne, (spec.ty) <br />Other: <br />SiN <br />SSOA's6 <br />7 -Eleven #19976 <br />U) <br />g <br />m <br />W <br />g <br />W <br />a <br />Sample <br />Matrix <br />8 <br />a <br />g <br />g <br />u, <br />E <br />E <br />Type <br />W.w1�r, <br />U.LS <br />4 <br />W <br />1i <br />E <br />A <br />4 <br />Sample <br />(G comp, <br />0 �" <br />2 <br />o <br />Sample Identification <br />Sample Date <br />Time <br />G - grab) <br />er.rhw..�.Ar <br />v <br />i <br />Special Instructions/Nota: <br />Preservation Code <br />cc <br />FIR <br />12114/16 <br />C"l� <br />G <br />S <br />x <br />x <br />x <br />x <br />x <br />x <br />x <br />akA-natl a f'(!Hive Soil <br />^' Z <br />�Inl S u <br />77 <br />> <br />c <br />i i li I I <br />320-24364 Chain of Custody <br />D v <br />I <br />Possible Hazard Identification <br />Sem le Disposal (A fee may be assessed if samples are retained longer than 1 month) <br />C = <br />O = <br />�Retum <br />Non -Hazard Flammable Skin Imtant Poison B Unknown Radiological <br />To Client Disposal By Lab Archive For Months <br />Deliverable Requested I It, III, IV. Other (specify) II <br />Special Instructions= Requirements. Email lab report to amends magee®stantec com. <br />patnck mcconnellgstantec.com, deborah lichlenberger(gstanteccom 1CDm <br />Empty Kit Relinquished by Date Time Metr DC a Sri Arrant <br />Ro lSgwsrao by <br />Dater me <br />Company <br />Date R me <br />Company <br />N <br />1 Z l41 1(o (LO�; <br />SrAjT E <br />t✓ Z <br />Z l 'Lits <br />��+� 7 <br />R9jmhed by <br />Ceterr me <br />Company <br />Received by <br />Dsterime <br />Company <br />Rdillifoushed by <br />Date/rime <br />Company <br />Received by <br />Cate,^urs <br />Company <br />Custody Seals Intact <br />Custody Seal No <br />Coder Tsmpena!u,eisl °C and Omer nema-ks <br />-% Yes <br />