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U12�& �q <br /> TestAnterica San Francisco TestrAtmedca <br /> 1220 Quarry Lane h., ,... :. <br /> T�(.� <br /> Cham of Custody Record <br /> TiG L;AD:ERIEN.ENVIRONMENTAL<TIESTIhG <br /> Pleasanton,CA 94566 <br /> phone 925.454.1919 fast 925.606.3002 TestAmerica Laboratories,Inc. <br /> Client Contact Project Manager: Binayak Acharya Site Contact:Chris McCormack Date, q737715 COC No: <br /> Environmental Cost Management Inc.(ECM) TeHFax: (661)255-1693 Lab Contact:Dimple Sharma Carrier: ECM of COCl <br /> 3525 Hyland Ave Suite 200 Analysis Turnaround Time Job No, <br /> Costa Mesa,CA 92626 Calendar(C)or Work Das(W): C <br /> (714)662-2759 Phone TAT if different from Below <br /> (714)662-2755 FAX © 2 weeks SOG No. <br /> project Name: N95tie © I week <br /> Site: Ripon,CA © 2 days <br /> P O#A © l day <br /> Sample sof <br /> Sample ldentWicati©n Sampk Bate Time Pres. Matrix Cour. Sample Specific motes: <br /> 0 <br /> 44 <br /> O <br /> 0 <br /> N <br /> 5725 BALL 2009 INF j HCl H.O 3 X a <br /> TB-®9j324 10 HC1 H-,O 2 x <br /> Preservation Used: 1=lee, 2=HCI; 3=H2SO4; 4--HNO3; S=NaOR;6=Other <br /> Possible Hazard Idlenl feallon Sample Disposal(A fee may be assessed if samples are retained longer then q month) <br /> r�ou-Ila ar d © Flammable © Skin Irritant Pois011;3 unA•no,rP ©R6turR To ClieAt mposel By Lab ©Amhive For Months <br /> Special lustructloas/QC Requirements& ©mments, No Geotracker <br /> Relinquished by: Company,Environmental DaWTi a: t�r�O Received by: Company:Test America Date,Time; <br /> Cost Management Inc. r3 Q f Y- 1 0. � \ - cl <br /> Relinquished by Company: a ime: Received by:. company: Date/Time: <br /> Relinquished by: Company: DatelTime: Received by: Company: DatefTime: <br />