Laserfiche WebLink
TestAmerica San Francisco � SZcy2, Tes 1 merica <br /> 1220 Quarry Lane Chain of Custody Record <br /> Pleasanton, CA 94566 -.rr ;(A7,fl ifazih,dk E. A. ;a-r=^• <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 720-10706.1 <br /> Client Contact Phone. E-Mail: Page. <br /> Shipping/Receiving dimple,sharma@testamericainc.com Page 1 of 1 <br /> Company. Job#: <br /> KIFF Analytical Analysis Requested 720-32186-1 <br /> Address: Due Date Requested: yg,: Preservation Codes: <br /> 2795 Second Street,Suite 300, 12/21/2010 <br /> '� A-HCL M-Hexane <br /> City TAT Requested(days): , B-NaOH N-None <br /> Davis h C-Zn Acetate O-AsNa02 <br /> D-Nitric Acid P-Na204S <br /> State,Zip. E-NaHSO4 Q-Na2SO3 <br /> CA,95616 V F-MeOH R-Na2S2SO3 <br /> Phone: PO 9 G-Amchlor S-H2SO4 <br /> n <br /> H-Ascorbic Acid T-TSP Dodecahydrate <br /> WO# N I-Ice U-Acetone <br /> Email: J-DI Water V-MCAA <br /> K-EDTA W-ph 4-5 <br /> Project Name. Project#, tj E' L-EDA Z-other(specify) <br /> Nestle-Ripon 72000256 " O <br /> Site. SSOW#: Z .i Other: <br /> H <br /> U <br /> Sample Matrix <br /> Type (W-water, O <br /> rd s ane U <br /> N Sample (C=comp o .ni u co <br /> LQ Sam le Identification-Client ID Lab ID Sample Date Time G— rab ern ..,MAo- rn ct <br /> 0) Special Instru ions/Note <br /> ��i� <br /> 1053 <br /> J RC-1 (720-32186-1) 12/7/10 Pacific <br /> Water X <br /> Hit 7717 Kiernan(720-32186-3) 12/7/10 Pact? Water X % <br /> Ln 1051 Robert(720-32186-4) 12/7/10 Pacific <br /> Water X 3 <br /> � P ifi <br /> E <br /> n <br /> �X <br /> �.a <br /> iP <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> =Non-Hazard 0 Flammable Skin Irritant Poison B Unknown Radiological =Return To Client 0 Disposal By Lab Archive For Months <br /> Deliverable Requested: I, II, III,IV,Other(specify) Special Instructions/QC Requirements: <br /> Empty Kit Relinquished by: Date: Time: Method of Shipment. <br /> CD <br /> O Relinquished by: Daterrime: Company Received by. <br /> Daterrime: Company <br /> O <br /> Relinquished by: Daterrime. Company Received by. Com an <br /> O <br /> Relinquished by Daterrime. Company Rive Daterfime.� <br /> Custody Seals Intact: Custody Seal Ill Cooler Te perature(s)°C and Other Remarks: V <br /> A Yes A No <br />