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rurueum r$SiPtr11@rEC3, 78CramentD <br />111I11lI111 1111111IIl11111111111111111lIII11111111111 880 Riverside Parkway Chain of Custody Record urofinsIirc nnrent iF•s:ii,y, <br />West Sacramento, CA 95605 <br />Phone,916.373-5600 fax:916.372-1059 <br />Sampler Cab PM Carnet Tracking Nor s) COC No <br />Client Information Sub Contract Lab Evans,Lauren R 320-203105.1 <br />Omni Contact Phone E-Mae Stale of Ongrn Page <br />ShippinglReceiving Lauren.Evans@Eurofinset.com California Page 1 of 1 <br />Company.Accreddations Required ISee note)- Jots R: <br />TestAmerica Laboratories,Inc. State-California;State Program-California 320-67359-1 <br />AddressClue I7nte Requested. Preservation Codes: <br />3355McLemoreDrive. 1219/2020 Analysis Requested <br />A,HCL M-HexaneGlyIATRequestedIdays): F NaDH N-None <br />Pensacola C-Zn Acetate Q-AsNaO2 <br />Slate,Lp U Moo Acid P-Na204S <br />FL.3251A v NaHSO4 0-Na2So3 <br />Phone pD# j MvOH R-Na2S203 <br />135D-474-1 ao1(rel) 850-478-2671(Fax) <br />is AmrJdor S-H2$Q4 <br />0 - H Ascorbic Acid T-TSP Dodecahydrata <br />Email' Wo# a — Ice V-Acetone <br />a o m J 01 water V-MCRA <br />H o K EDTA w-pH 4-5prosectNamer"olect#. o c I EDA Z•othef[spaGfyy7-11 No 2D632(CA)32014426 m °° 2 <br />a c <br />Site ssows 0 u Other <br />w v <br />Sample Matrix a d <br />Type <br />Sample (C=comp, ..";,. m .aSamtoidentification-Client ID Lab ID) Sample Date Time G rats) r,f=ii...i.n-a, <br />UB <br />a r- S ecial InslntcrionsiNote: <br />Preservation Code: XX I <br />10:27 1?-JulD-1-4[320-67359-1] 1211120 SolidPaPacificX 1 <br />cD 10:41 11-Jul <br />w D-2-4(320-67359-2) 1211120 Solid X i <br />v P cific <br />p TP-1-14.5(320.67359-3) 1211120 <br />10:34 Solid X 1 <br />5t-Jul <br />Pacific <br />0PacificpTP-2-14.55 320-6735 4) 1211/20} <br />10:45 Solid X 1 <br />11-Jul <br />TP-3-15.5(320-67359-5) 1217120Pacif0' Solid X 1 <br />44.023-0 <br />ic <br />TP-4-15.5(320-6735") 1211120 <br />11:07 Solid X 1 <br />11'Jul <br />P it <br />P-1 4(320-67359-7) 1211120 <br />11:23 <br />Solid X 1 <br />1 t Jut <br />Pacific <br />Note.Since Iabpral ry accreditauons ere Subpact to change,Eurains TestAmerica places the ownership of method.analyte 3 a[Credltatenn Ampllance upon out subconuacl laboratories This sample Shlpmenl iS rdrwarded under chatn•et-custody If the labdr®tery does not currently <br />maintain acreditation in the State of Origin h5ted adore for a rtalysmItestvMatnx being analyzed.line samples must he shipped back to the Euroflns TeslAmerica labciiatory or oMer instruclions roil be provided Any,changes to accmditallon status should be brought to Eumfins <br />TostAmenca attention Immediately If a I requested accred-10ons are current to dale.return the signed Chain of Custody atlesmg to said plrtance tp EuroRns TestAmenq <br />Possible Hazard Identification Sample Disposal(A fee may he assessed ref samples are retained longer than 7 month) <br />Unconfirmed I 0 Return To Client 173 Disposal By Lab Archive For Monlhs <br />Deliverable Requested:I,II,III,IV,Other(specify) Primary Deliverable Rank:2 Special InstrectionslCC Requirements: <br />Empty Kit Relinquished by:pale: Time:P08406 Of shtpmem <br />Raltnquished Da Z_ Company Received by <br />Relinqum y: 0alefTlme: Company Received by. Datalrime Company <br />NRelv,quished by Dalcrrlme. Company ftecelred by Datelrime Company <br />Custody Seals intact: Custody Seal No.. C.00mr Tamperalure(s)'eand inner Remarks <br />N Ver:i 101+2020 <br />dCD