Laserfiche WebLink
Eurofins TestAmerica, Pleasanton 1� II���� <br /> Plea Quarry Lane Chain of Custody Record tiff eurofins Environment Testing <br /> Pleasanton, CA 94566 TestArnenca <br /> Phone:925-484-1919 Fax:925-600-3002 <br /> Sampl,er. Lab PM Carder Tracking No(s) COC No: <br /> Client Information Sub Contract Lab) Gonzales.Justinn elf 720-42722.1 <br /> Client Contact Phone E-Mail, State of Origin Pape <br /> Shipping/Receiving <br /> Ijusfinn-gonzales@testamencainc.com California Page 1 of 1 <br /> Company Accreditabons Required(See note) Job It <br /> TestAmenca Laboratories,Inc 720-93886-1 <br /> Address Due Date Requested: Preservation Codes: <br /> 17461 Derian Ave. Suite 100, 7/1 112 0 19 Anal is Requested A-HCl_ M-Hexane <br /> City TAT Requested(days): 6•NaOH N•None <br /> Irvine C-Zn Acetate 0-ASNa02 <br /> State,Zip. w D-Nitric Acid P•Na204S <br /> CA,92614-5817 'e t"'r E-NaHSO4 O-Na2SO3 <br /> w �' F-McOH R-Na2S203 <br /> Phone- PO# o s G-Amchkx S-H2SO4 <br /> 949-261-1022(Tel) 949-260-3297(Fax) w 3 $ H-Asconon Aad T-TSP Dodocahydrate <br /> Emad WO# . > I-Ice U•Acetone <br /> c n CiE J-DI Water v-MCAA <br /> Project Name Protect X. ,�, ' 0 K-EDTA W-pH 4-5 <br /> UPRR-WR#21633 44015945 A i L-EDA Z•other(specify) <br /> H <br /> Site SSOW# E ti @ -5 a Other: <br /> Sample Matrix X a j <br /> D V J <br /> Type (w-..i..•a-..na i i , "' <br /> Sample (C-comp' <br /> Sample Identification-Client ID Lab ID Sam Ie Date Time G rab) er.rr,..__ $ $ g Special Instructions/Note: <br /> PTei�xyaMon. <br /> CSD 001(720-93886-1) 7/3/19 Pacific Solid X X X X X X 1, <br /> w <br /> tit 002(720-93886-2) 713/19 Pacific Solid X X X X X X <br /> O <br /> W <br /> v <br /> Note.Since laboratory accreditations are subject to change,TestAmenca Laboratories,Inc.places the Ownership of method.analyte d accr"tetion compliance upon out subcontract laboratories.This sample shipment IS forwarded under cham-of-custody If the laboratory does not <br /> currently maintain accreditation in the State Of Origin listed above for analystsAestshnabrx being analyzed,the samples must be shipped back to the TestAmenca laboratory or other instructions will be provided Ary changes to accreditation status should be brought to TestAmenca <br /> Laboratories.Inc.attention wrimedtately If all requested amreditabons are current to date,return the signed Chain of Custody attesting to said Complicance to TestArnerica Laboratories,Inc. <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed If samples are retained longer than!month) <br /> Unconfirmed I Return To Client Disposal By Lab Archive For Months <br /> Deliverable Requested,I,Il,111,IV,Other(specify) Primary Deliverable Rank:2 Special Instructions=Requirements: <br /> Emply <br /> ,JWZ1I,3jWshed by. Date: Time: Method of shipment <br /> 1�Alinquished D e' Company � Received b. � � Date/Tlm � Congan <br /> rA <br /> 1 e <br /> IZetnquis Dy Da .me Company y Date ime Company <br /> v <br /> Relmqui y Dote/Tame Company Received by DateTme. Company <br /> tit <br /> N Custody Seals Intact: Custody Seal No.: Cooler Temperature(s)-C and Other Remarks' <br /> es A No z'� �3 <br /> Ver,01/1612019 <br />