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TestAmerica San Francisc o -70mw- 3co <br /> 1220 Qtiany Lane TestAmenoca <br /> Chain of Custody Record LGAOcEADER.. <br /> THE R IN ENL•EROIti'M1"NTFG TESTING <br /> Pleasanton,CA 94566 <br /> phone 925.484.1919 fax 925.600.3002 TestAmerica Laboratories,Inc, <br /> Client Contact Project Manager. Binayak Acharya Site Contact;Chris McCormack Date: —7,7-60 COC No: <br /> Environmental Cost Management Inc.(ECM) T*Wax: (662)235-1693 Lab Contact:Dimple Sharma Carrier: ECM of COCs <br /> 3525 Hyland Ave Suite 200 Analysis Turnaround Time Job No. <br /> Costa Mess,CAA 92626 Calendar(C)-Work Days(W): C <br /> (714)662-2759 Phone TAT if d'sifiemat from selaw <br /> (774)662-2758 FAX 2 weeks SDG No. <br /> Project blame: Nestle Q 1 week <br /> Site: Ripon,CA Q 2 days N <br /> P O# 1 day �� M <br /> t� <br /> >iQ <br /> Sample #or > i`'O <br /> Sample Identification Sample Date Time Pres. matd Coax ir, Sample S ecific Notes: <br /> 802 VERA ERF 1 j;r0 HC1 H,0 X j� f <br /> 802 VERA MID 'q;16- HCl 11>0 X r <br /> 802 VERA INF 10 �(�;�� HCI H,0 X N <br /> 44 <br /> O <br /> N <br /> N <br /> M <br /> ro <br /> a <br /> Preservation Used: 1=Ice, 2=HCI; 3=IUS04; 4=I U3; 5-Na0H;6=0tber <br /> Possible Hazard Identifteadon Sample Olsposel(A fee may be assessedif samples are retained longer than 4 month) <br /> V-1 Mon-Hazard © Flammable Q Sk-w Irritant Poisoj;] U"k,rnvll—' =Re-turn To Client �Disposal By Archive For monft <br /> Special 1nstruetiouslQC Requirements&Comments:NO GEOTR.�CKFR <br /> Relinquished by: Company;Environmental Date!Tme:iT 1�, p ec by; Company:Test America Dat Tim <br /> Cost ivlanagement,Inc. .��_/(� '�� fG� <br /> R b CxT y: Dat i 1: Recei Com Date/Time. <br /> Relinquished by_ Company: Date Time: RewiveZ by: Company: Date Time: <br />