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Tei= mov C-5I San Frand—se-o10f <br /> 115 ,� o <br /> 1230 Quarry Lane �� ` d ca N <br /> o 64M*16 am -- cy–Est 3c!-, <br /> Pleasardcu,CA 94555 <br /> phone 925.48.1919 fax 925.600.3002 TestAnnerica La;orate es,`=ire. <br /> 77 Client Contact Project rvzartagen.. B6:ayak Aeharya ISKe Contact:Marnr Czipka s e: CCC NO <br /> Enwonmental Cost Management inc.(ECM) TetTax: (66I)255-1693 ILO Contact:Ditaple Sharma Samp3ec: of COCl <br /> 3525 Hyland Avenue, Sutt9 200 a A.nslyb Turnaround Job No <br /> Costa Mesa,CA 92626 Calendar(C)or Work Days <br /> (714)662-2759 Phone TAT ifdafferritfmmBelm l ; <br /> II i <br /> (714)662-2758 FAX ® 2 weeks ,I ; SDG No. <br /> Project Name. {pestle D 1 week <br /> x <br /> Site: Ripon,CA <br /> PO# lday <br /> I � <br /> "3aEIlEkle t€aE d i O S � � <br /> Sampie IdentificationE Sample Date Time pre3. Cant Sample Specific Notes_ i <br /> i6si RO BBB3 5HCI H201 3 6 X I I � <br /> HCI H2O 3 X <br /> N <br /> O <br /> N <br /> N <br /> t� <br /> CU <br /> a_ <br /> 720-57935 Chain of Custody <br /> Preservation Used: 1–Ace, 2=HCI; 3=H2804; 4=HNO3; S=NaOH;6=Other <br /> Posstbre HazardIderrVwation Sample Disposal(A fee maybe assessed IF samples are retained longer than 1 month) <br /> ® Non-Ha.:ard © Flammable 0 Skm Irritant Poison B© Unknown © Return To Client ®Disposal By Lob QArchive For Months <br /> Special instrucdons/QC Requirements&Comments: NO GROTRACKER. <br /> 3" <br /> Relinquished by: G=Pwy)_n—t-,Cost Date/Time: �(� Received by DatefTime: q <br /> mwa hu ent, Aany: ASS' L - 9 <br /> Relinquished by. Company: Daw,'Time: Received by. Company. ri gime: <br /> Relinqu shed by. 1 Company: Date/Time: Received by: Company. Dakgmre: <br />