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StateofCalitamia - <br /> EnvlrontnantalProtacdonApanoy Deparanamot7oxid Sabsiances c=t t <br /> anvftorvnantal cmhfsti Lab.",y <br /> AUTHORIZATtON REQUEST FORM(ARF) <br /> Part A:Requestor's Inforrnatfon <br /> RequeStor's Nartfe: Anne Ekker -^—__ Emaic axrne.eleker d{ v__® Phone. 7114845309 Q PPt-Frx>:etrAi <br /> aarx-up Requestor. L)ylan Clark Ell' Atan.dark@Iftc cagov Phone; 9162553731 (Chock If u PTO.ntd Rewwwl <br /> i <br /> sue Name Fhatdrer Comuany of CeliFomla.Stockton <br /> Expected'sample Amval Rate: 11129X2018 _ <br /> TumarG(trd'nme(TA-f): *Rush <br /> 1eVe11 ❑ 2 0 3 ❑ 't/nRchiofs approvetrdqubad{forRvsh orTATtevet=tj_ <br /> Project to: � D7Tcgtygq ty to; 36195 MPC- 962_ _ —... <br /> Part B: Project ObjeC#1YO-8}or&PP(tduesuons7 ECL Point of Contact ECL Sample Management Officer at SM0FF@dtsc.ca.gov,(510)59A�17-S} <br /> Project .ate classification <br /> Objective: <br /> special Wearefnspectin9 ac2femfcafmanufactureranddfsMbW)Ut facllRy;trey arekrrown to manNacture ftfeac42 productsaMother industrint cleanin <br /> g prnduds. Fromodreragency <br /> InfmmiiMY fispactton reports,+sa aro Predicting coliecting Samples ofvatlous wilds,Sludges,and liquids. <br /> Part C.Analysis Information <br /> Analysis Name Tact Code NumbarM Comments <br /> samples <br /> W PH <br /> ..._..�_...—._.._.____.—....o-___.._._..:___ <br /> __ EPR 904t)CR90450 t;oirwiye uquld 4 <br /> MamissanjlG Me tats,no Meroafy�.�-_. ECL05Af725.00.EPh Bq oc Waste Water '1 Do ltr aRgQ55 <br /> _._.�_�._,... .._.._.._.._ _._. regardless <br /> ._. - <br /> CA <br /> Part 0:(sy seeo-ECL} ^ - <br /> Authorization Nurnber(AN) 1$EG'(iQ51 <br /> Lab to Receive sample(a) Envlrunmental Cherrilsvy 4b-9erkeley <br /> 710 Hei=rtz Ave,Sulte 150,Berkeley,CA 9#710 <br /> Attn:Xavier Montalvan(510)540.3111 <br /> - -----" sample Management OrBcer(SUP) Frandsco Montatvan - <br /> ARFAppruvalOate 11130!2018 (mm/ddyy) EiVratfon.Date IZ7/2018 ..__(MWddyy) <br /> ARFRevisfon Data —.- _ (mmfddlyy) ARFRevisedby <br /> TamlmaadTlrn*frATy 'RtUh TorpafYae heats andfaNQr ar ameraaneR 'favaltsiadaya, 2-30daya, 3.4sdgy - <br /> NA-NefAppae W <br /> Pagel nil 07,d446Aanyi_atl0i2b1s_Appidvad by AualjtyManagamantOHkar <br />