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❑ ❑ ❑ ❑ L e <br /> 00 <br /> 0 <br /> TestAmerica San Francisco N <br /> 1220(1narrpLane TestAmerica CVo <br /> Chain of Custody Record <br /> rti; ,rs't7kPIN[rvv!srk,va+t runt :;srnr C: <br /> Pleasanton,CA 44566 <br /> phone 925 484 1919 fax y25 600 3002 TestAmerica Laboratories,Inc. <br /> Client Contact Project Manager: I2inayak Acharya Site Contact:hark Ccipka Date: s COC No <br /> F-CM Consultants !'ell Fax: (662)255-1693 Lab Contact:Dimple ShBTMU Sampler: t _ of coos <br /> 3525 Hyland Ave Sutte 200 Analysis Turnaround Time Job No <br /> Costa Mesa,CA 92626 Calendar I C 1 or W ark Days(W) C <br /> (714)662-2759 Phone €Ai fdifferentfartr➢elox•______ W <br /> (714)662-2758 FAX © weeks N SDG No <br /> x <br /> Project Name Nestle D I meek m <br /> Stte Ripon,CA 0 days <br /> P0* D Iday e <br /> 0. <br /> {J <br /> Sample ant O <br /> 7 <br /> Sample Identification Sample Date Time Pres. Matrix C-1- Sample Specific Notes <br /> TB- ��I U�1 (� Ll <br /> ;(( 1ICI 1120 2 X <br /> MW-5 C) HCI H2O 3 X <br /> MW-11 ��• � HCI H 0O 3 X _ <br /> 00 <br /> OCL 11JU <br /> 0 <br /> M tkL, r zoX 0) <br /> CUa <br /> M-i&A X � r)CL H,tj ; <br /> ft)- 16Cr i s6 WL lard `7 <br /> M- 6C'! v� L' I` �6 WL fFu <br /> X11-A C )°kL ti�.G <br /> Preservation Used: I=lee, 2=1ICI; 3=HZS04; 4=HNO3; 5=NaOH;6=Other <br /> Passible Hazard Idewifrarion Sample Disposal(A fee may be assessed if samples are retained longer than J month) <br /> © N4nr-Hu.ur i = Hunn1uh1v n s nr Iry rrurn fixer:n B= t rnknnwn =Return To Client ©Disposal By Lab =Archive For Months <br /> Special Instructions/OC Requirements&Comments: REPORT DATA IN EDF FORMAT GLOBAL ID SL205012989 <br /> �s <br /> Relmgmshedby Company Environmental Daiegf to { ] Receive b Com n DalPe <br /> e /) jj�} <br /> Cost Management,Inc G f d"J Ll y ,��11��W } 6 f q [V <br /> Relinquished by Cornpagv Dater ring Rec d b Company DWT e <br /> /6 [� 1 ZIP — y:A 7zcl �z �c <br /> Relinquished by Company Dater'Ttme Received by Company Date/€rme <br />