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❑ 1-1 1111 e 1 15T <br /> f es4A e ssa San Frp-ndse^ 75 ? Z& % It <br /> 1220QuatxyLane ' D <br /> VV <br /> Chain of Custody ecord � <br /> TFJz tc�cR YN St�ViTe6:+ir•��'aAi T-,!riPfG N <br /> Pleasanton,CA 94566 <br /> phone 925494.1919 fax 925 600.3002 T eseriea 1`aboratories,I:Ee <br /> Client Contact Project Ymnager: Bivayak Acissrya Isite Contaej:Ilam"pka Date: (9 ;;S COC No: <br /> Environmental Cost Management Inc (ECM) Tei/Fax: (661)255-1693 LaE Contact Dimple Sharma Sampler rndF of COCs <br /> 3525Hyfand Ave Suite 200 Analysis Turnaround Time �,.;_ II _Job Ila. <br /> Costa Mesa,CA 92626 Calendar(C)or Wort:Days(W): C <br /> i <br /> (714)662-2759 Phone -rkTif&ffr==m Bel— <br /> 0 <br /> (714)662-2758 FAX 0 2 weeks �s f SDG No. <br /> Project Name: Nestle © 1 week <br /> Site: Ripon,CA 2 days <br /> f <br /> PC# ILD Iday <br /> Y <br /> Sample #of y e <br /> K s <br /> Sample identification Sample Date yTime Pres. YA tt i:: CoaL Sample Specific Notes: <br /> $- � 61h-f � �5 FOCI 11z0 2 1XI I X i <br /> EU3&EU4F-FF '3 vim® HCI Hp 1 3 1 X ` I X <br /> EU3&EU4MM o-7-a6 HCI I�,O 3 X X <br /> EU3&EU4]KF 0 HCI HO 3 X X <br /> 1 0 <br /> _00 <br /> if <br /> I� <br /> 720-5$261 Chain IIIUS y <br /> Preservation Used. 1=lce, 2=13 t 3=H2SO4; 4=E[NO3; 5--NaOH;6=Other <br /> Possible H"2!rd Identlfw4 ian Sample Disposal(R fee maybe assessed!€samples are retained longer than 1 month) <br /> ® Non-Hazard =Flammable S7m:Imtont Parson B 0 UnkuOWn =Retum 7b Client ®Disposal By Lab Archive For Months <br /> Special Imtrtactions/QC Requirements&Cnramesets: REPORT DATA LN LIDL+ FORMAT GLOBAL IID SL2i650IZ989 <br /> Relinquished tryA� <br /> Company:Environmental DateJ/T� �1e 1Ze v 8y: Company:Test Amerca Date/Time, <br /> Cost Managemeot,Inc. �1 � LJrs � & �-1'( Q <br /> Relinquished by Company, atelrime: Received Company Date/'rime. <br /> Relinquished by: Company- Date/Time: Received by Company: Date/Tmae: <br />