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❑ F-I LI LI ® 13-?-'!`Ik1- <br /> TestAmerica San Francisco 7M -2�1 A <br /> ?o7 <br /> 122U Quarry Te te�mencao <br /> Chain of Custody Record <br /> SHE LEADER IN ENVIRONMENTAL TESTING (V <br /> Pleasanton,CA 94565 - <br /> phone 925.484.1919 fax 925.690-3002 TestAmerica Laboratories,Inc. o <br /> Client Contact Project Manage(: Siasyak Acharya Site Contact:Chris McCormack hate:8-9-2011 CAC- No: <br /> Environmental Cost Management Inc.(ECM) Tel/Fax: (661)ISS-1693 Lab Contact:Dimple Sharma Cartier. ECM of C'CK s <br /> 3525! Land Ave Suite 200 Analysis Turnaround Time Job No. <br /> Costa Mesa,CA 92526 Calendar(C)or Work Days 4 C <br /> (714}582-2758 Phone TAT ifdiffemnt feom Below £R <br /> (714)652-2758 FAX El 2 weeks SDG No, <br /> Project Name: Nestle © 1 vxek <br /> Site: Ripon,CA © 2 days <br /> m <br /> P 0# © I day ;e <br /> Sample@f O <br /> Sample Identification Sample Date Time Pres. Matrix Cons Svnple 5lxcifx Notes: <br /> TB-080911 9:912011 11:40 HC! H,© 2 X <br /> EU3&EU4 ID2 8911'2011 12:35 HCI H2O 3 X <br /> rn <br /> 0 <br /> 00 <br /> a� <br /> cc <br /> d <br /> Preservation Used: i-lee, 2=HCI; 3=112804; 4=13NO3; 5=Na0R;6=Other <br /> Possible Hazard lde nfiraiiouSample Disposal(A fee may be assessed it samples are retained longer than 9 month) <br /> E] Lon-ya=ar d M Plonsrr ble © Skrrr lT,itarat Porsmf{-a]—� Unk-tenp =1Return To Client ED Disposal By Lab �Amhive For Months <br /> Special ifu5tnxtl0nslQC Requiremeav,&comments: REPORT DATA IN EDF FORMAT GLOBAL ID SL205012989 <br /> �•Z C- <br /> Relinquished by: r] Companc•:Emiron mental Da&,,Time: Ree ed by: Conipaln-:Test.-Unerica 4Dairae' <br /> im <br /> cflst�lanaTe�t Inc, g-y-�] 1r3 �a <br /> Relin quished by: Company: Dated€me: R ived by: Company: : <br /> Relinquished by: Company: Date Time: Received by: Company: Date/Time: <br />