Laserfiche WebLink
Received by: <br />Rev 02/05/2019 CHAIN OF CUSTODY <br />SAN JOAQUIN COUN <br />ENVIRONMENTAL HEALTH DE <br />1868 East HazeIton Avenue, Stockton, <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 <br />TA number: <br />Sampler's <br />name: <br />Title: <br />,cr 523 <br />fLj6ter-d tri-e9A 5.terldisff <br />i‘c,•L tt130 <br />Relinquished by: <br />Received by <br />Relinquished by: <br />Received by: <br />Relinquished by: <br />Name <br />Fedea Fret-e37 <br />Y <br />Please send results to: <br />Name: Era 6.-7:frle-'511- Email: <br />'ARTMENT <br />CA 95205-6232 <br />Web: www.sjgov.org/ehd <br />:ORD <br />ritrreri4tr@site4c.o.r4 /gbackus@sjgov.org <br />tvw; ; 95'kiv, e 5.1 ,)•osi . 0 ir-n <br />*EI-ID staff to call for further instructions: <br />-- e r r‘Q•54- ,S'"'i `3b ° • c'r..5 <br />Required analysis TTLC, Title 22 California Code of Regulations (CCR) 66261.74(a)(2)(A)_ TCLP„ Title 22 CCR 66261.24(a)(1)(B), if necessary , (CALL RHO STAFF BEFORE RUNNING FOR FURTHER INSTRUCTIONS) STLC, Title 22 CCR 66261.24(a)(2)(A), if necessary ' (CALL EHD STAFF BEFORE RUNNING FOR FURTHER INSTRUCTIONS) Cam 17 metals, Title 22 CCR 66261.24(a)(2)(A) Chrome VI, Title 22 CCR 66261.24(a)(2)(A) "Fine powder" measurement (Particle size <100µrn in diameter) Ignitability, Title 22 CCR 66261.21 Reactivity, Title 22 CCR 66261.23 Corrosivity (pH) , Title 22 CCR 66261.22 Sc, <br />[a <br />Cr-‘,1 <br />r-i <br />SD INI <br />SD Co <br />CC <br />U <br />U <br />fN NJ <br />C) <br />7-2 I— <br />>- Cs <br />ra <br />0 <br />:r3 <br />.= <br />'5 o .c <br />Lip <br />cm <br />c<fi EY-lb w AA- -7 -1-1_c_ re6A-s• <br />Title Date <br /> <br />Re, F/111, Ye4111^ •Crak14—' / <br /> <br />7;e, 1112.51z/ <br />Remarks <br />CHAIN OF CUSTODY RE <br />Time <br />7; (16 <br />2 : ed.-, <br />Sample container description <br />Unit: <br />Sample address <br />Facility name: Cerlytt <br />Facility address: -7 11 6;41,402 St-*J.10., <br />Facility contact: Loyed-f-- 13e- <br />Sample location Sample <br />number <br />Sample source <br />description <br />Date <br />sampled <br />Time <br />sampled Method of sampling: Composite (C) Grab (G) Evidence tape: Yes (Y) No (N) Transported in iced cooler: Yes (Y) No (N) Cofwey-cr&eti-- ree_,0 (6it-e ii11112i <br />11/11/21_ 7- floor1t 6ree, (okerett, 146-z <br />6