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ce.4n2lytica!" <br /> CA Regulated Soil Notification <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. / 13 <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 /> 6unty <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): t�( T�ai, C <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:��/n-r-d� d <br /> Lab ID(if applicable): <br /> Are Samples Regulated? No ❑ Yes <br /> Regulated for? ❑ Phytop o ora 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 Pi 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 />