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TestAmerica Pleasanton I IIII Iall I II III IIIIIul�I IIIA II III <br /> 1220 Quarry Lane Chain of Custody Record p TestAmenca <br /> Pleasanton, CA 94566 <br /> THE L.E A DER IN ENVIRONMENTAL TESTING <br /> Phone(925)484-1919 Fax(925)600-3002 <br /> Sampler: Lab PM: Carrier Tracking No(s): COC No: <br /> Client Information (Sub Contract Lab) Sharma,Dimple 720-30549.1 <br /> Client Contact: Phone: E-Mail: Page: <br /> Shipping/Receiving dimple,sharma@testamericainc-com Page 1 of 1 <br /> Company Job#. <br /> Aquatic Testing Laboratories Analysis Requested 720-74752-1 <br /> Address: Due Date RS ted: {/ Preservation Codes: <br /> 4350 Transport#107, 10 16 A-HCL M-Hexane <br /> City equested(days): B-NaOH N-None <br /> Ventura ;` C-Zn Acetate 0-AsNa02 <br /> State,Zip: n D-Nitric Acid P-Na204S <br /> E-NaHSO4 Q-Na2S03 <br /> Phone: <br /> o F-M80H R-Na2S203 <br /> fr; <br /> hmPO#: -�{ m - G-Amchlor S-H2SO4 <br /> H-Ascorbic Acid T-TSP Dodecahydrate <br /> Emal: WO#: ; t-Ice U-Acetone <br /> J-DI Water V-MCAA <br /> Project Name: Project#: <br /> sox = K-EDTA W-pH 4-5 <br /> UPRR-Stockton-Monthly Oil&Grease 72004592 y t L-EDA z-other(speciry) <br /> M <br /> Site: $SOW#: a Other: <br /> m <br /> i <br /> Sample Matrix ; <br /> Yp <br /> Sample CType <br /> m (s_nlla. ? � ` <br /> Sample Identification-Client ID Lab ID Sample Date Time G= rab BT•T-r­�AY V=1 ►,' Special Instructions/Note: <br /> im <br /> (D 11:34 <br /> N MR505 UPRRST160927(720-74752-1) 9/27/16 Pacific Solid X n[ <br /> 41 s. <br /> O <br /> —n <br /> IV <br /> v <br /> f4. <br /> tl: <br /> w I <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> Unconfirmed Return To Client =Dispose/By Lab Archive For Months <br /> Deliverable Requested:I,II,III,IV,Other(specify) Primary Deliverable Rank:2 Special Instructions/QC Requirements: <br /> Empty Kit Relinquished b Date: Time: Method or Shipment: <br /> ORelinquished by_ Dateriilge:z Company Received by Date/Tlme // Company <br /> RO— ishe Dale Ime: Com ny Received /• Date/Time, company <br /> fV <br /> Q Relinquished by Dale/Time: Company Received by Date/Time: Company <br /> M <br /> Custody Seals Intact: Custody Seal No.: Cooiw Temperatures) c and other Remarks: <br /> Yes A No <br />