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7estAmerica Pleasanton T��� �� ��� <br /> 1220 Quarry Lane U0 Record <br /> Pleasanton, CA 94566 & <br /> Phone(925)484-1919 Fax(925)604-3002 v <br /> Sampler <br /> tE <br /> �.., 12 Career Tracking No(s) COG No <br /> Client Information p r L�4 k rzs�" S� 720-49422-12434 1 <br /> E�� t,t��� <br /> Ciienl Contact Phone <br /> Michael Villa Real S"t'^�•Ls�" try Page <br /> 1G) `_�00 - j �J @testamencalnc coin Page 1 of 1 <br /> Company Job# <br /> Union Pacific RR Operations eProcurement Analysis Requested <br /> Address Due Date Requested: Preservation Codes: <br /> 1400 Douglas Street Mallstop 1040 <br /> '�`l A-MCL M-Hayane <br /> O TAT Requested(days): B-NaOH N-None <br /> Omaha <br /> C-Zn Acetate 0-ASNa02 <br /> State,Zip4'!' D-Nitric Acid P-Na2045 <br /> NE,68179 W c E-NaHSO4 0-Na2SC3 <br /> v W F-Me0H R-Na2S203 <br /> Phone PO# m° m 6 G-Amchlor S-HZSO4 <br /> 562-490-7045(Tel) 758471 0 n m m m H-Ascorbic Acid T-TSP Dodecahydrale <br /> EmaiF WO# a e 1-Ice U-Acetone <br /> MMVILLAR@UP COM o a °� a °> J-U Water V-MCRA <br /> - w E 9 m K-EDTA W-pH 4-5 <br /> Protect Name protect# yin ,'0' m nt n w c t c L-EDA Z-ocher{specify) <br /> UPRRStockton-Monthly Oil S Grease 72004592 m '.m, a z m _ <br /> Site 5Sow# <br /> E i a a -� A N C u fl[har- <br /> N � <br /> Sample Matrix 2! y G w M Ts <br /> V U <br /> 'O <br /> y v E A zE 3:9=soL4 Vi Ci Vi di r Z <br /> Sample (�=Camp, O=wasrcion' m o o N <br /> Sample Identification Sample Date Time G=grab) aT-T1 ...A' .r Ud r 1— Special Instructions/Note- <br /> on Code: X N ID q IN_13 A ID IN <br /> Water <br /> N 1 Water <br /> Co <br /> o Water <br /> W <br /> 720-92832 Cham of Custody <br /> t, <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> =Non-Hazard =Flammable Skin Irritant Poison 8 Unknown © Radiolo ical =Return To Client ED Oisposal By Lab Archive For Months <br /> Deliverable Requested I,It,III,IV,Other(specify) Special Instructions=Requirements <br /> Empty Kit Relinquished by Date. Time Method of Shipment <br /> Relinquished by Daten'imrer t Cor pany Receiv OatelTijT�e <br /> TP-4 <br /> om an <br /> 3 1 U T <br /> ReEi�by <br /> DateRim� � 7 fCompany n tl by Oate/TimeRelDateiTirre Company Received by Oaterrime ComPr <br /> N d� <br /> O <br /> N) Custody Seals intact. Custody Seal No, Cooler Temperatures)ac and Other Remarks <br /> O a Yes A No <br /> O Ver 08/0412016 <br />