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address is required.) <br />ust be checked against APHIS interactive maps to <br />)112ce Analytical' <br />CA Regulated Soil Notification <br />USDA / APHIS regulates material with organic matter, includiig soil, from specific <br />counties that have invasive species, pests, or plant diseases 1resent in the county. In <br />order to process your project, we need to determine if special handling applies to your <br />project. 12 ,1673 <br />Any soils received without this completed form cannot be received or processed until <br />the site address is confirmed. <br />Receipt of Soils from California: <br />Are,samples soil or other regulated material? <br />Yes 0 No It no, matrix description <br />County <br />Alameda 0 Contra Costa LI Humboldt 0 Lake 0 Las Angeles* 0 Mann <br />Mendocino 0 Monterey 0 Napa 0 Orange' 0 Ri rerside* 0 San Francisco <br />San Mateo 0 Santa Clara 0 Santa Cruz 0 Solano E1 Sonoma 0 Trinity <br />Other (specify): CA O7‘Qua-10 <br />(If (If soils are from one of the 18 counties specified above, t e site <br />Site Address: <br />Fire Ant and •• Fruit Fly quarantines may be partial county quarantines. The site address <br />determine if the site is within the quarantine area. <br />To be completed by Pace National: Client: <br />Lab ID (if app cable) <br />Fire Ants 0 Fruit Flies** <br />grams <br />Will any analysis be done at another lab? <br /> <br />O Yes 0 No <br />Are Samples Regulated? N' No El Yes <br />Regulated for? 0 Phytophthora Ramor UM <br />Amount of soil received: — <br />Received on: <br />If yes, complete the following for each lab that will receive the regilated samples: <br />Receiving lab notified soils are regulated? Shipment <br />Receiving Lab Amount shipped_ sent with receiving lap's Compliance Agreement? <br />Yes (initial / date) <br />g Yes (initial / date) <br />g Yes (initial / date) <br />g Yes (initial / date) <br />Soils cannot be transferred to another descnation without a Pro 530 form. Contact lor, Krug at Jordan,c1 krug@aphfs.usdis2y. <br />Initial / date after a copy of form has been sent to Anthony Jackson, USDA PHIS PPQ <br />HAQAQC\ Public \ Controlled Docs\ DAV-31 CA Regulated Soil Notific tion.docx DAV-31 <br />Rev 2 <br />7/17/20