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------------------- ------------------------------------- <br /> TestAmerica Chain of Custody Record 308576 . TestAmeka <br /> cramento <br /> 880 Riverside Parkuay tl.ay <br /> P'cc,F. Man��as' <br /> Heat Sacrarwe#EO: ch mos SUS t,ren �� Z2t THE LEADER 1N ENVIRONMENTAL tE5712 <br /> �> e: 915-973.551Ip Fax: TestRmericaLaboratories,Inc. <br /> Regulatory Program: Q Dw ❑wDEs 0 KCRA other: TAt-821010713) <br /> Client Contact Project Manager. tL4Q int Site Contact: pr};a t Date: q Sgt q COC No: <br /> company Flame: t pr, Te[lFax:t �U — '- �?a Lab Contact: (rL . Carrier: of COcs <br /> Address: Analysis Turnaround Time Sampler: <br /> CitylStatelZiP: ❑CA VVW DAYS WOWNG DAYS r For Lab Use Only: <br /> Phone: p TAT if different from Below Z Waik-tn Client: <br /> Fax: ❑ 2 weeks Lab Sampling: <br /> Pm*1 Name: `. d i week <br /> Site: ❑ 2 days m Job f SDG No.: <br /> P4# ❑ iday <br /> Sample ai <br /> Sample Sample is-camp EE <br /> #of <br /> Sample Identification Date Time rrcrasl Matrix cone. t <br /> p a Sample Specific Notes: <br /> SL(OtS1 V3 (a5 a <br /> S`got8t 'z- <br /> N) <br /> O <br /> W <br /> 440-243052 Chain of Custod <br /> a HCt, 3 H2Sp4;'4=ffNQS' <br /> Presantafloei Usod. lee„ 2- 5-Nat?H,15a Other <br /> Possible Hazard Identification: Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> Are any samples from a listed EPA Hazardous Waste? Please List any EPA Waste Codes for the sample in the <br /> Comments Section if the lab is to dispose of the sample. <br /> []Non-Hazard 0 Flammable Stan lnitent ❑PoLwn B ❑unknown ❑Return to Client Q 4lspasal by Lab ©Atchtve ror_ Months <br /> Special Instructions/QC Requirements&Comments: <br /> EX 4M 5 541 1450;— 12) 1 <br /> Custody <br /> 4541— <br /> Custody Seals Intact: ❑ Yes No Custody Seal No.: )Cooler TerN.("C)'. bs, o d: Therm 10 No.: <br /> 'shed by: Company: Date/Time: ce y: Company: DateiTime. <br /> !g!R r--rkc� 5(o!i 3o gp Flo <br /> a lnquls Co to ime: R e e Company: Dateffime: <br /> N is Company: Dalemme: R eived in Labors ry by Compan 17 tem . f <br /> CD � <br /> CO W <br /> nn n <br />