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TestAmerica San Francisco „/V �� stAmedc <br /> 1220 Quarry Lane Chain of Custody RecordMINIMUM <br /> Pleasanton, CA 94566 tali <br /> Phone(925)484-1919 Fax(925)600-3002 <br /> Sampler. Lab PM: Carrier Tracking No(s). COC No: <br /> Client Information (Sub Contract Lab) Sharma, Dimple Page 14.1 <br /> Phone: E-Mail. Page: <br /> Client Contact: Pae 1 of 1 <br /> Shipping/Receiving dimple.sharma@testamericalnc.com g <br /> Job#: <br /> Company Analysis Requested 720-29640-1 <br /> KIFF Analytical Preservation Codes: <br /> Address: Due Date Requested: <br /> 2795 Second Street,Suite 300, 8/12/2010 A-HCL M-Hexane <br /> B-NaOH N-None <br /> City: TAT Requested(days): <br /> >1 C-Zn Acetate 0-AsNaO2 <br /> Davis D-Nitnc Acid P-Na2O4S <br /> E-NaHSO4 Q-Na2SO3 <br /> CA 95616 Zip F-McOH R-Na2S2SO3 <br /> Phone: PO#: G-Amchlor S-H2SO4 <br /> H-Ascorbic Acid T-TSP Dodecahydrate <br /> s� N 1-Ice U-Acetone <br /> Email: <br /> a <br /> WO#', +L' 1° J-DI Water V-MCAA <br /> a .. K-EDTA W-ph 4-5 <br /> Project Name: Project* Or L-EDA Z-other(specify) <br /> Nestle-Ripon 72000256 _ other: <br /> Site: SSOW# <br /> Sample <br /> Matrix ' <br /> Type (W.w.r., p 2? <br /> s-.olid, m <br /> b Sample (C=comp, o-w.at.juu, <br /> W <br /> � Special Instructions/Note: <br /> ion-Client ID Lab ID Sample Date Time G= rab er Ti u.,A AI r <br /> Sample Identificat <br /> (D41 <br /> ��. <br /> OD <br /> ru <br /> 15:25 Water X z vl <br /> 0 5725 HALF EFF(720-29640-1) 7/29/10 Pacific <br /> ��st <br /> a <br /> w <br /> i <br /> Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> Possible Hazard Identification <br /> =Non-Hazard =Flammable Skin Irntant Poison B Unknown Radiological Return To Client Disposal By Lab Archive For Months <br /> Deliverable Requested: I,11, III,IV,Other(specify) Special Instructions=Requirements: <br /> Method of Shipment <br /> (n Empty Kit Relinquished by: <br /> Date: Time: <br /> (D Date im Com y r— Received by. Date/Time. Company <br /> J Relinquished <br /> o o J <br /> Company <br /> p <br /> 0 Date/time: Date/Time: <br /> Company Received by. <br /> 00 Relinquished by: <br /> Company Received lo Date/Time: -f_ Compa <br /> RelnQ 24 o <br /> Custody Seals Intact: Custody Seal No.: cooler re erature(s)°C and Other Remarks: <br /> � Yes D No <br />