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r Z- <br /> 00 <br /> TestAmerica San Francisco N <br /> 12?0 Okiarn Lane Test m!�Gy hca <br /> wrzv maw Y5 Chain of Custody Record , <br /> --�Ut3'fi ENV F�l J.h't;,SAL wS 3lii C: <br /> Pleasanton,CA 9-{566 <br /> phone 425 384 1919 fay 925 600 3002 -festAmerica Laboratories,Inc. <br /> Client Contact Project Manager: Binavak Acharva Site Court"-.Mark Ciipka Date: ') ( 0)c No <br /> FCM Consultants I'elfFax: (661)255-€693 Lab Contact: Sampler: ?etc w,)j C of _ COCS <br /> 3525 Hyland Ave Suite 200 Analysla Turnaround Time Job No <br /> Costa Mesa,CA 92826 Calendar(C 1 or Wart:flays(W V C <br /> (714)662-2759 Phone <br /> (714)662-2758 FAX © 2 week,~ SOG No <br /> Project Name Nestle I week *! <br /> Site Ripon,CA 2 days <br /> PO# C7 Iday <br /> Sample qo! W <br /> Sam le Identification Sample Date Time Pres. W+triz Com. a Sample Specific Notes. <br /> M-7A 4 i S-JL None 11,0 I X <br /> A one X . /jlt7ll-/"- j}7C <br /> O <br /> c'7 <br /> ill <br /> CU <br /> 720-05896 Chain of Custody <br /> Preservation Used: I—Ice, 2=111C], 3=112S(14; 4=1-S03; 5=NaOH;6=Other <br /> Possible Huard ldefttifiration Sample Disposal(A fee may be assessed if samples are retained longer than?month) <br /> © Vcue-Hu urd =1 Hummuhic SAM frfcfu,u I'wvm B� ibikncnivr � ©Return 70 Client E�JDisposal By Lab Archive For Months <br /> Special Instructions/QC Requirements&Comments: REPORT DATA IN EDF FORMAT GLOBAL ID SL205012989 <br /> r <br /> Rel€nyui,hed hq Company Env€ronmentaE Datef€-me I Received by Company Test America Dat [riless <br /> J Cost Management,Inc /LJ At 0�f y✓ !S C <br /> Rcimguishedby Company DatefTime Receive y- Company Datel'tme <br /> Rehnquixhed by Company Daterrane Received by Company Daterl€me <br />