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Excelchem Environmental Labs <br /> DTE Stockton,LLC Project: Ash <br /> 2526 W.Washington St. Project Number: [none] Date Reported: <br /> Stockton,CA 95203 Project Manager: Dan Crawford 03/01/17 17:19 <br /> iampl-e frikegrity - WORK {3RI]FR : 1703002 <br /> Datc Deceived: O2,12 31201 7 <br /> Section 1—4e,r ple Al ivilI Info. <br /> Sample T!Ymmpon; $ CELCii'YEM Courier Transportod In: Box <br /> Mcri;: ibe type of packing inamrials: None <br /> Has chilling process begun? No Samples Recoived: Ambient <br /> Temperature of Sumples("C): l6 Ice Chest"fcmgeratnre{s} ( C)--NIA <br /> Section 2—8010*1A-O sis Inco. <br /> Yes No WA 0a.h.—U <br /> ENO;f31 battles wive unbroken and intact? x - <br /> Did ail battle labels agreo with COC? x -Were correct conini ners used fr,r the tGsls rcqmcrtcd7 x <br /> Were oarree[1m%eSCrv;4tiUns llsad for the tests uestcd? x <br /> Was;a AmfTfi4irns a mount of sample sent for tcsis ind Leased? x <br /> Were bubblcspirhrul i31 VQA Vials?:(Ynlntile Methods Only) - <br /> See-Lion 3 — SurnxnQfFl<)w regulator Info. <br /> 'Meed Sme unalk <br /> Untmwd Summttlk: <br /> Cleani 3u uYmn#; <br /> R ulnlaril= <br /> Was there any uisual darisage L1>!!;urnma canisters Gr Flow regulators' Explain. <br /> Section 4—COC Info. <br /> 03 Leled r r,,F— lctcd <br /> Yen No C'ootoo— Ytn No Comments <br /> Was 00C Ra[�Cived x - Analysis Requested x <br /> Date Sampled x SwnRlcs arrived within holding gime x <br /> Timc Sampled 74 - Any hail simcs loss than 72 hrs x <br /> samp3e ID x Client [Mame x <br /> Rush TAT x Adckor,%Tclephone# ]L <br /> Soctioo S—Comments f Dlserepaneies <br /> Was Client notified of discrepancies! N/A Norified by, N/A <br /> Ex lana ions!C�pmmpn#�; - <br /> Samples Latrclwby: 11. Filled r Date:V1/17 <br /> out <br /> 8115#s: DEPT,L I by; !'irnr 09:52 <br /> OOC'ecenneWAn¢hrdny! JL. <br /> ,liample IabeLti reviewed JL - <br /> by; <br /> DRAFT REPORT The results in this report apply to the samples analyzed in accordance with the chain of <br /> custody document.This analytical report must be reproduced in its entirety. <br /> Laboratory Representative Page 2of3 <br />