Laserfiche WebLink
Irvine TestAmedca <br /> 17461 Derian Ave <br /> Suite 100 Chain of Custody Record <br /> THE LEADER IN ENVIR2N MENTAL TESTING <br /> Irvine,CA 92614 <br /> phone 949.261.1022 fax 949.260.3299 TestAmerica Laboratories,Inc. <br /> Client Contact Project Manager: Site Contact: Date: +q&"— 3/)o/ 16 COC No: <br /> Nahid Toossi Tel/Fax: Lab Contact: Amy Harris Carrier: _1_ of_I COCs <br /> 2120 S.Yale Street Analysis Turnaround Time Job No. <br /> Santa Ana,CA 92704 Calendar(C)or Work Days(W) W y <br /> 714-429-4355 TAT i£diMTent from Below_5 days <br /> S _IGI lGr% GB-, 2 weeks SDG No. <br /> Project Name:O'Reilly 1 week e,O <br /> Site:3576(15315 Culver Dr.Suite 170,Irvine 92604) 2 days <br /> P O# 1 day <br /> Sample Sample a of <br /> Sample Identification Sample Date Time Type Matrix Cont y F v Sample Specfic Notes: <br /> Brake Shaving 3/10/2016 Solid 1 I X X X <br /> �i <br /> 440-140719 Chain of Custody <br /> Preservation Used: 1=Ice, 2=HCl; 3=H2SO4; 4=HNO3; 5=NaOM 6 Other <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 m&M) <br /> 0 Non-Hazard =Flammable Skin Irritant Poison B 0 Unknown Return To Client X Disposal By Lab Archive For $onths <br /> Special Instructions/QC Requirements&Comments: <br /> Relinquished by: Nahi Tt2o si Company:Safety-Kleen Date/Time: Received by: - Cornpa�Y: Date/Time: <br /> Relinquish id Company: Date/Time: keceived by: Company: Datefrime: <br /> elinquished by: Company: Date/Time: Received by: Company: Date/Time: <br /> rn CJ 0/Zb.� <br />