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ARLi <br />A & R Laboratories <br />1401 Research Park Drive, Suite 100 <br />Riverside, CA 92507 <br />V: 951.779.0310 a 600.798.9336 F: 951.779.0344 <br />officeCrDarlaboratories, cam <br />kRvi'i3 <br />JUL 2 E 20114 <br />ENVIRONMENTAL 'HEALTH <br />DEPARTMENT <br />A & R Work order is <br />Chain of Custody Record 1205-00005 <br />Page _hof I_ <br />Tum Around <br />Dnnu entad (r9r le aeDrecrialel <br />Project No: Project Nams: <br />SAFE <br />� <br />Q <br />m <br />t <br />a <br />-- - _ _ _ <br />O 24hr RUSH' <br />046hrRUSH* <br />ONormal <br />• <br />1205-00005 Unified Grociers, Stockton <br />ProJset Menaper. Phone; Fea: <br />Jennifer lni uez 951-779-0310 1 951-779-0344 <br />Cuetamr Norm: (R".n — eeral SUM Address: M.- nrw <br />A & R Laboratories 1401 Research Pk. Dr., Ste. 100 <br />'PRIOR MP -1. <br />eddiw o r-, wall <br />-`A ary <br />Emelt: CRY, Stall LP <br />iennifer iniauez .arlaboratories.com Riverside, CA 92507 e <br />Lab 0 Sample ID Grab/ Date Tune Sample Container g <br />a,oswr (A,d,liuid.oP.rmr.pon) Comp aamDled sampled mUrfx •&Type <br />speehl tmtruNldn• <br />Clarifier Grab 61712012 10:35 Water 2.96orRIHDPE <br />X <br />11R :t er'e 1 ON.: 111mll,Wi►T:MW. <br />Time: al Refl�i,Me br:wft: <br />Tyne: <br />Dlsposa) <br />O ReamTon <br />Q Lab Disposal <br />I <br />R.. by: Deft: e CT <br />— <br />Tnu:2) <br />Report Delivtty ats Unless other <br />tree a.caondroe. mmpadMa]!!rgPe.p <br />Samples Chilled Custody Seals f. be <br />es Intact ?�� ry ❑ Paper Q EMAIL ❑ XL5 amdgements are <br />�es ONo Q Yes i No rier C Walk In made sedges will ae <br />❑EDD, Type dhPoaad of eo days <br />From Feld/Fed Ex ❑ EDF, EPA Site ID sMr eaeDt <br />Laboratory Notes: PleaSe CC: marilu.escher®arlaboratories.com <br />_ _.. ____ oennurra . MOBILE 1 ARORATORIES • COSMETICS <br />CHEMISTRY • MICROBIOLOGY • FOOD SAFE I r ' ..vna�mcr lr�. � .-•- <br />TM d R—Y o/..n+l.e &Rd the RWWWn en W e -MM ar—Wy sum eeMaWru eu,nadretbn r<Mrbnn W. en.ry....pee~ -n" the remu end ca.dMbN ell MrN nn We uta nIl'eel <br />MN C.ee • CM.1 Gel <br />aMY Gry • edel.tl 11..weeM e.w�..1 TWA dMT'. 4 Rl� <br />