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❑ ❑ ❑ ❑ L e <br /> 00 <br /> 0 <br /> N <br /> TestAmerica San Francisco \_ <br /> TestAmefica <br /> N <br /> 1220(?harry 1 ane � <br /> Chain of Custody Record _;ADcIimtiNr-nonr.,ty.a... <br /> Pleasanton CA 94566 <br /> phone 925 484 141 y fax V25 600 3002 'fest Nmerica Laboratories,Inc. <br /> Client Contact Project Manager: 13inayak Acharva Site Contact:Mark Czipka Date: to jjCOC No <br /> EGM Consultants Tel/Fax: (6611255-t693 Lab Contact:Wimple Sharma Sampler: r• L4 2i) of _COC-, <br /> 3525 fi land Ave Suite 200 Analysis Turnaround Time Job No <br /> Costa Mesa,CA 92,526 Calendar(C)or Work Days(W) C <br /> (714)662-2759 Phone "tA"i,f d+rT rcai fsun,9ciuw __ ___ <br /> (714)662-2758 FAX ® 2 weeks SDG Na <br /> ry <br /> Project Name Nestle CI I week r <br /> m <br /> Site Ripon,CA Q 2 days <br /> P O# [� I day <br /> a <br /> 4ample 11 O <br /> Sample ldentirication Sample nate Time Pres. Matrix Conr. � Sample 5 ci9ic lwSot�s <br /> HCI J120 3 X <br /> } } [-ICI H2O 3 X <br /> HCI H2O 3 X N <br /> O <br /> f t f 1 1120 3 X <br /> S—LLC �r }� �� 110 H2O 3 X <br /> 110 1120 3 X <br /> "Cl H2O 3 X <br /> " HCl H2O 3 X <br /> HCl H2O 3 X <br /> rl 1114 C—_ a t .0 Li HCI H2O 3 X <br /> R HCI H2O 3 x <br /> V�A—`�S �`. 11C2 1120 3 X <br /> Preservation Used: 1=Ice, 2=HC1; 3=H2SO4; 4—HNO3: 5=NaOH;tr Other <br /> Passible Ha;ord Ideirnfieadon Sample Disposal(A fee may be assessed if samples are retained longer than 4 month) <br /> ® Mon-fla:ard E�] I•Iam,nable SAM IrWrOU Pwwn HD Unknown ©Return To Cfienf �Drsposa18y Lab =Archive For Months <br /> Special Instructions/QCRequirements&Comments: REPORT DATA IN EDF FORMAT GLOBAL. ID SL205012989 <br /> Relinquished by Company Filwonmental Date(i'nne- Rece»ed by Company Fest A€nenca Date4rim <br /> Cost Management Inc Ali <br /> � ')3 IL Y 0 �Z7 <br /> Ftelmquishedby Company Da1e/lnne Receive Comp y D teJi,€me <br /> Gam-` � '� (� �`I5 }�- ] � �f❑❑/ � 5�sJ` <br /> Rehngn€shed by Company Date1T€mc ecened by Company Ila€e T€me <br />