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Test America <br /> co Client Name/Address. Project/PO Number <br /> o Erin Zavarin-Arcadis/UPRR Tracy,CA-Maintenance Facility <br /> w 1050 Marina Way South ANALYSIS REQUIRED <br /> m Richmond,CA 94804 PEDD 2480-02-RevO <br /> _ o <br /> p N N <br /> Project Manager/Phone Number. Phone Number <br /> Erin Zavarin/510-233-3200 x143 ) Jt/`(/-�� <br /> 2 Io <br /> H! m <br /> Sampler: Ail <br /> Uf'mff� �)W xNumber 0 <br /> Sample SampleContainer of Sampling Special <br /> Description Matrix Type Containers Date/Time Preservation Instructions <br /> r, r1 <br /> WG-2480-MW-17A- V �g WGZ y� ' ,/� X <br /> WG-2480-MW-15B-(gn09J WG 10..45 YVdrJE. X MS/MSD <br /> WG-2480-MW-14B- 9 Kvt WG 2 f I .Lp X <br /> WG-2480-MW-15C• 90';DV WG I -00 X <br /> W WG-2480-MW-01 C-Oq 650 WG Z 12 i 5o X RUN SILICA GEL <br /> w <br /> CLEANUP ON ALL <br /> 3 WG-2480-MW-16B-090t>D J WG 2— i 3:� X SAMPLES <br /> W <br /> 09 y WG-2480-MW-12B- O`--Z WG Z X <br /> w WG-2480-MW-11BR- V� WG Z 1S o f X <br /> CAI <br /> w <br /> WG-2480-MW-08A- 09 0503 WG [� X <br /> G X <br /> VJ6- ZLM-r-VOI \A/61 - 2 x <br /> Re, <br /> Received Received by: <br /> �41Turnaround Time: (check) <br /> w Datelfime: Date/Time, <br /> `n 0 0 q� �0 3lrB <br /> o Same Day 72 Hours <br /> o ZS <br /> (Z;/� <br /> Relinquished By Received by: 24 Hours 5 days <br /> Date/Time: Date/Time: <br /> 48 hours normal X <br /> Relinquished By Received in Sample Integrity: (Check) <br /> Date/Time. Lab by: <br /> Date/Time <br /> tact On Ice C-� Custody <br /> Note:By relinquishing samples to Test America,client agrees to pay for the services requested on this chain of custody form and any additional analyses performed on this project.Payment for services is due within 30 days <br /> from the date of invoice.Sample(s)will be disposed of after 30 days. <br /> m <br /> 0 <br /> w <br />