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Received By: <br />Received By: <br />Date_ <br />& Time <br />Date <br />& Time <br />J.R. Simplot Company <br />P.O. Box 198 <br />Lathrop, CA 95330 <br />209-858-2511 Jacob Staley <br />SEND RESULTS TO ALL PARTIES LISTED BELOW: <br />209-275-4362 (cell) <br />Jacob.Staley@Simplot.com <br />Project ID NA Project Pond cleanout contractor spill <br />Name: <br />Remarks: <br />COLLECTED BY: Krista Kinsey <br />SPECIAL <br /> Test sample "7492/7496/2392/2805" for TTLf.and <br />INSTRUCTIONS: Test sample "P'2963" for TTI pH, and TPH. <br />( ) CAM 17- TTLC <br />ANALYSIS <br />REQUESTED (X) Other, Note above in Swcial Instructions Section <br />( ) 8 Metal TCLP <br />( ) STLC 10X Only \ <br />TURNAROUND <br />TIME <br />48 llours, but we need <br />results by the end of the <br />day on May 20. <br />Sample ID Lab ID Collection <br />Date <br />Matrix Notes or Sample Map, Etc. <br />Soil PT2963 <br />7492/7496/2392/245 <br />5/20/2021 <br />)5/20/2021 Soil <br />Relinquished ByzJacob S <br />Relinquished tiy: <br />Date <br />& Time ; <br />Date <br />& Time <br />Send Sample To: Enviro-Chem, Inc. Laboratories <br />1214 E. Lexington Avenue <br />Pomona, CA 91766 <br />Ph: 909-590-5905 <br />Fax: 909-590-5907 <br />CA-DHS ELAP Certificate #1555 <br />CHAIN OF CUSTODY RECORD