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Stale of Canfomia Depanmenl of Toxic Substances Conaol <br />CaSW.11 EAww" oval Pwreclion Agency Environmental ChemiaN LabuawrY <br />SUPPLEMENTAL ❑ <br />AUTHORIZATION REQUEST FORM (ARF) enac. a sw,rla..n.l Reauesxel <br />PART A: (By Requestor - PLEASE PRINT) r17nitchrefs signature required <br />Turnaround Time CWT): 'Rush ❑ -Level 1 ❑ 2 {2 3 ❑ (for Rush or TAT Level = 1) <br />Requestors Name flan _Clad( _ Email dclark Qdlse.ca.gov Phone( 916) 255.499L_ <br />Regan 01-Saaan•rortl0Unit EBERP-ofr.a d Cnmanal_I_m•euiaaums Fax( 916 )255-6446 <br />Back-up Requenor Gil Whipple Phone( 916 ) 255-3607 <br />Site Name Oakland Bag _- -- _ _ mucodr -- - - <br />PART B: Analytical Requests (By Requestor) (Lab uses default methods listed haipw. Please specify all other requests.) <br />Inorganic Analysis <br />Number of Samples/Type <br />6olidlLi4UidtWater.0lhe Organic Analysis <br />Number of Sampleslfyp <br />soldlLqudWate other <br />%Dry SOlids (ECL ___ <br />Atldiy (306-1) <br />_ _ GRO (caw me. 80158 _ <br />ORD Diaseq only (ECL816-ht) it <br />- --� <br />Alkalinity (310.1)_---- —_� <br />_ Motor Oil only (ECL816-M) <br />Anions by IC (055) --- <br />CMomium vl(Cln try Colorimetry (7796A) <br />Chromium vl(Cra) in Water by IC (7199) <br />DRO(Dtese118 Motor 01(ECLBt&M) <br />EMyleneGfycol (ECL772-M) <br />-T-,_.. PSDEs (ECL750-M) <br />Cyanides fw Wastes,l.eachates (9010B) <br />PCBs (8082) <br />Hardness (130.2) <br />I '_ Pesticides- Chiwinated(8081At <br />00ercury(Hgl in Solids and Liquid (7473) <br />-- <br />--� Pesticides - Or9ahophosphater (8141 A) <br />Marcury(Hg) in (Sarni)Solid Waste (7471 A) <br />1,4 -Dioxane (ECL830-S) <br />Memury(Hg) in Liquid Waste (7470A) <br />Metale Screening by XRF <br />ODMS Semivolatiles (82700) i <br />3 l olatllea (82806) <br />Metals Sun (80106. for As.BLCu,Po, etc) <br />Metals Sun (tor Drinking water, 6020A)I <br />OrgenoLead in Wane (ECL93&M) <br />HPLCICarbonyI Compounds (8315A) <br />Explcsrves (8370) <br />IPAI (8310 <br />Panicle Size (ECL740-S) <br />' DbxlnslFurons by HRGCIHRMS (ECLB80-M)T— ' <br />PerUtbnte (w SOB,Shdge (ECI 95SM) _ <br />Flash Point (1020A) 3 <br />Perchlorate for Water (31&0)Hexa <br />pH (904q9. 90450) <br />-, TXO-Told Hangers in O'g (ECL792S) <br />Total Dissolved Solids (760-1) <br />lotharo. typel <br />in) IBTX on a _ <br />_ <br />WET(ECLa105) 0*'f� -W ❑p.hryram <br />_ <br />I(elan."in) _. <br />(anon. type NI <br />otel. type n) 1 . <br />TCLP Anal sisea <br />Other Analysis <br />Metals our wa.asrserY ps urwNxa <br />Fish Bioassay (illi 22) _ <br />Qslr jr MfaWry U.uRa.41W <br />Mercury _ ❑ <br />Congener PCBs (ECLC-P <br />GCB) <br />voladks u0r,•u�,.eW.n o.nRo�a.o <br />! C_w_tgener PBDE% (ECL-CG-PBDE) . <br />sam""a6nsoar an.wr.p o.:na.eW <br />(amen.lYpe lir) <br />(Others. tym in) <br />-i <br />(o8wa�, u•7pe "N) _ .._. __ <br />Analysis Objective <br />Waste Classification <br />Special Instructions or Comments (For Example: [)election Limit, Sample Preparation. Extraction,,., etc J: <br />Please have Lloyd cat after the XRF results are in so I can decide what tests to ask for further. Please relydgersie the samples. <br />Expected Sample Arrival Date: <br />_ _ 02111111 _ (mmlddyy) <br />PART C : (By SMO - ECL) <br />Authorization Number (AN) <br />Lab to Receive Sample(s) <br />ARF's Revision No. 4I <br />1 D Initials: Jz Date: <br />-Y-' <br />EnvirommanW Chemistry Lab ARPS Revision No. <br />700 Heinz Ave. Suk• 130 Initials: Date: <br />Sample Management Officer (SMO) J/s n Alin: Loyd Witham$ (510) 540-3189 <br />7WYY'�0�'T7- ❑ Check box If Cancelled <br />_ / 1 Initials Date: <br />Today'& Date J y� /J{ (mm/dd/yy) Expiration Date _7 r __ (mmlddlyy) <br />If Sample(s) Directed to Cont 'roc—(6 Please SPecity <br />Reason: ECL Personnel Confirmed. <br />-.. _ <br />ECL CdnlraU Lati ager N68firatwn (1oTRusFi or TA7Level =1): <br />Turnaround Time fTATI: - Rush for public health am safety or emareianry, -Level 1 = 15 days, 2 .30 days, 3 • 45 days. <br />T CLP : It lime permits and sample macer type n appropriate, rib may anayze or sateen ine sanu l (s) firm a determine d TCLP s neeaed- <br />n.x»nue erl Ilaers Manna/ FC. ns rRNMHm <br />