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❑ ❑ ❑ ❑ L e <br /> 00 <br /> N <br /> TestAmerica San Francisco0540 <br /> '0072f). <br /> Ql.tanr L..'1[10TestAmedca N <br /> Chain of Custody Record <br /> Plea;<anion,CA 91566 <br /> plione 9'_'5.9£54 1919 fa,,925 600 30112 TestAmerica l.uboratories,Inc. <br /> Client Contact Project Manager: Itinayak Acharya Site Contact:Mark('zipka Date: ,5 (��� COC No <br /> ECM Consultants Tel/Fax: (661)255-1693 Lab Contact:Dimple Sharma Sampler: C `tet, _ i _ 04 _l J COOS <br /> 3525 Hyland Ave Suite 240 Analysis Turnaround Time Job No <br /> Costa Mesa,CA 92626 Calendar(C y or Work Days(W) C <br /> I714)662-2759 Phone TAT of kfrewnt from below <br /> (714)662-2758 FAX ?weeks SDG No <br /> Project Name Nestle 1 ucek <br /> Site Ripon,CA days <br /> P O 11 0 I day rv <br /> LJ <br /> Sample Identification Sampte Date <br /> Sample <br /> Pres. Matri% c-W. 2 720-86540 Chain of Custody — iample Specific Notes <br /> 11cl 1120 2 1XI <br /> 7501 KIERNAN 2008 EFF t � 1 HG H2O 3 X <br /> 7501 KIERNAN 2008 MID HCI 1120 3 X cCY)�l <br /> 0 <br /> 0 <br /> N <br /> N <br /> 5725 HAIL 2009 EFF L�`1•� HC1 1120 3 K co <br /> a_ <br /> 5725 1IALL 2009 MID Ott 11cl 1120 3 X <br /> Preservation Used: 1=Ice, 2=HCI, 3=1112SOA; 4=FIN03; 5=Na011;6-Other <br /> Possible Ha;ard IdendfleatPnn Sampfe Disposal(R fee may be assessed ifsamples are retained longer than'I month) <br /> © ,yg,n_jfai Mrd =1 i(mnrnuhle Q N'hW Irrni,rnr 1'u,vn,B 1 inbwvvn ©Return To Client ®Disposal By Lab =Archive For Months <br /> Special lnwuctionslOC Requirements&Comments: NO G FOTRACKER <br /> r� L <br /> L <br /> Relingrnshed by % Company BalerTurie Reccne Company Test Aimtrwa Dat imjr Ae <br /> ECM Consuhantc 5! J� II � V/1 ;7 1�v <br /> Retmquislted by ✓ Cotnpan� Date77tn;eued by Company Dale,Time <br /> Relinquished h)r Compam Daie Tnne Received by Company Date''Ttmc <br />