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TestAmericaTESTAMERICA <br /> Reference#: 6r G $�S861 San Francisco Chain of Custody <br /> 1220 Quarry Lane • Pleasanton CA 94566-4756 <br /> THE I- ADER IN ENVIRONMENTAL TESTING Phone: (925)484-1919 a Fax: (925)600-3002 Date 06-04-19 Page of <br /> Report . Analysis Request <br /> Attn: A%3V 2-&,i PS R S _ <br /> d I X 0 co N a <br /> Company: (jNILO"CTti CON3TfuC(�6tJ C.O. ca m s 4°❑ o O ❑❑ o °° O ❑ ❑ <br /> ep O ❑m tD N co ❑ N E a7 cn O O <br /> Address: <br /> 6#lL0t7rl /frv>rMI(r SAWA 443 A ❑ ❑'❑ ¢ c> W 04 <br /> N 0 0 CO ❑ LL a E d Q ❑❑ <br /> ❑ — c� o� m r4N a� mao w o E ❑❑ <br /> �>< � + O o s� U <o QQ o v -J >. == 00 c <br /> Phone: Email: ilf��' ,w m N c� <br /> CU <br /> Bill To: Sampled By: CG✓� °°m o❑ o o m o°p m 0❑ LLJ❑o❑ w oNo tz O �r ❑❑ <br /> plJJ D Q ao a =a mo wo m� ❑ ❑ u� ai ° mL 0 5m3 U <br /> r w 01 CO N cy 2 O .J f" f>6 N U <br /> ¢� da a— y dw O- 5 C7ro ayi T �� ❑ .. m% uia x min ❑❑ O <br /> a 3 W W p a y co a a o >f0 U d2 ,y <br /> Attn: Phone0 7 78-otx5 w 9 a'U d Q °¢ v 0) a 3:if x a rn <br /> xc7 w n- dLL °'Oj mw w ma ym ¢ <br /> Sample ID .. - �❑ am �f � ❑ a? >°l iri❑ o�' as a rix erv. c¢iW �❑ �z_ ❑❑ ❑❑ ❑❑ ¢` Z <br /> Ob/o3 0:30 <br /> v <br /> CD <br /> N <br /> CD <br /> O <br /> W <br /> 720-93317 Chain of Custody <br /> _ _ ._ _ 1)R 'nquish� 1 2)Relinquished by: 3)Relinquished by: <br /> Project Name: #of Containers: C ', C4 i°x <br /> 0141 (q$0 ALAAAO S Signature Time Signature Time Signature Time <br /> Project#: Sg(vl Head Space: <br /> Awee,-o <br /> PO#: 5861 Temp: ` r C� Printed Name Date Printed Name Date Printed Name Date <br /> l• &WL-aT t t C6NS1V,c9l0wJ CO. <br /> Credit Card#: Conforms to record: Company Company Company <br /> TJ 5 1)Receiived by: 2)Received by: 3)Received by: <br /> A72 48h 24h Other: <br /> T Day ,r L; <br /> Report: ❑Routine ❑Level 3 ❑Level 4 ❑EDD ❑State Tank Signature Time Signature Time Signature Time <br /> Fund EDF ?1) <br /> Special Instructions/Comments: ❑Global ID '"?.r'! r � . { z_%t, <br /> rdnted Name `Date Printed Name Date Printed Name Date <br /> _1(- <br /> Corr6pany Company Company <br /> See Terms and Con ns on reverse <br /> N `TestAmerica SF reports 8015M from CS-C24(industrynorm. Default for 80158 is CID-C28 Rev02109 <br /> O <br /> O, <br />