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TestAwerica San Francisco <br /> 1220 Quatry Lane Tesu _ 1 E! <br /> Chaim of Custody Record TH11 �ADER I ENVIRONME FAL TrSON <br /> TttE LEAbEIl IN EiJVSE20NP.7EYThL TCSTSF�G <br /> Pleasanton,CA 94566 :770 <br /> • 30 <br /> phone 925.484.1919 fax 925.600.3002 TestA,mEerica Laboratories,Inc. <br /> Client Contact Project Manager: BinsyakAcharya Site Contact:Joseph Plummer Date: M-7110 . COC izo: <br /> Environmental Cost Management Inc.(EGM) el/Fax: (661)255-1693 Lab Contact:Dimple Sharma Carrier: E M of COCl <br /> 3525 Hyland Ave Analysis Turnaround Time Job No. <br /> Costa Mesa,CA 92626 Calendar(C)or Work Bays(W) C <br /> (714)662-2759 Phone TAT if digbrent fr m Below <br /> (714)662-2758 FAX © 2 weeks SDG No. <br /> Project Name: Nestle © I,mak <br /> Site: Ripon,CA © 2 days m <br /> PQ# iday <br /> v: <br /> SampleNal � c <br /> �- <br /> Sample Identification Sample Date Time <br /> ` Pres. Mat CO- a � Sample Specific Notes: <br /> �7i0"' � !/� HCl HO x <br /> HCI H;O x <br /> HCI H'O x <br /> HCI HIO x 7N <br /> O <br /> HCl H20 x <br /> Cl HO x <br /> U) <br /> ro <br /> a <br /> Preservation Used: I=Ice, 2=HCI; 3=H2SO4; 4=HNO3; 5=NaOH;6--Other <br /> Possible hazard Idenrefleadan {{�--- Sample Disposal(A fee raay be assessed!f samples are retained longer than month) <br /> 0 Non-7Yazmrl © Flan2mable © Suri L•r•irant Poisoj;3 Un noivP ©Return.To Client Disposal By Lab ©Archive l`or Months <br /> Special InstructionslQC Requirements&Comments, REPORT DATA 1\EDP'FORNNu.T GLOBAL Ila SL205012989 <br /> -T 1 7e_ <br /> RelinquishXs� Company:Environmental Datellipw Company:Test America Datee i e: <br /> cog Management,Inc. 0141 `���' �. !- 7[D 1 f I <br /> Relittqu by; VCompany: Date/Time: Received by: Company: Datell'ime: <br /> Relinquished by: Company. DatoTime: Received by: Company: Date/Time; <br />