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Pace/lnalylical" <br /> CA Regulated Soil Notification� ' ��15�y <br /> USDA/APHIS regulates material with organic matter, including soil, from specific <br /> counties that have invasive species, pests, or plant diseases present in the county. In <br /> order to process your project, we need to determine if special handling applies to your <br /> project. <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 ❑ No If no,matrix description: <br /> County <br /> ❑ Alameda ❑ Contra Costa ❑ Del Norte ❑ Humboldt ❑ Lake <br /> ❑ Los Angeles* ❑ Marin ❑ Mendocino ❑ Monterey ❑ Napa <br /> ❑ Orange* ❑ Riverside* ❑ San Francisco ❑ San Mateo ❑ Santa Clara <br /> ❑ Santa Cruz ❑ Solano ❑ Sonoma ❑ Trinity <br /> Other (specify): moo_, t;,,cgNAAv,, <br /> (if soils are from one of the 19 counties specified above, the site address is required.) <br /> Site Address: <br /> 'Fire Ant and"Fruit Fly quarantines may be partial county quarantines. The site address must be checked against APHIS interactive maps to <br /> determine if the site is within the quarantine area. <br /> To be completed by Pace National: Client: <br /> Lab ID (if applicable): <br /> Are Samples Regulated? 9,po ❑ Yes <br /> Regulated for? ❑ Phytophthora Ramorum ❑ Fire Ants ❑ Fruit Flies** <br /> Amount of soil received: ` grams <br /> Received on: <br /> Will any analysis be done at another lab? ❑ Yes ❑ No <br /> If yes, complete the following for each lab that will receive the regulated samples: <br /> Receiving lab notified soils are regulated?Shipment <br /> Receiving Lab Amount shipped sent with receiving lab's Compliance Agreement? <br /> 9 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 destination without either a PPQ 530 or PPQ 540 form. Contact APHIS before proceeding. <br /> Initial/date after a copy of form has been sent to Luis Oquendo, USDA APHIS PPQ <br /> H:\QAQC\Public\Controlled Docs\DAV-31 CA Regulated Soil Notification.docx DAV-31 <br /> Rev 5 <br /> 7/21/2021 <br />