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KIS CHAIN OF CUSTODY RECORD <br /> SEND RESULTS TO ALL PARTIES LISTED BELOW: <br /> KLEASM Fionn O'Neill Fionn@kleenblast.com <br /> Industrial Services <br /> 50 Oak Court,Suite 210oy may) } ,, y vi 'FAX-ZM--152.-5�yy <br /> Danville, CA 94526 1•` (I <br /> Phone 925-831-9600-Fax 925-831-9183 ki tlii SOlu�tot5 <br /> Nlir eber. SSD-1 -► CLIENT: 5 � C 'PA i n-'I V S01 u+b YIS <br /> roeslrE: ` p t �5 i rl <br /> COLLECTED BY: <br /> SPECIAL <br /> INSTRUCTIONS: <br /> CAM 17-TTLC,STLC 10X RULE,TCLP as needed SELECT TIDE X72hrs Standard Rate <br /> ANALYSIS f 8 Metal TCLP TURNAROUND ( ) 48hrs SR+25%Premium <br /> REQUESTED ( V Metal STLC .TIME DESIRED BY ( ) 24hrs SR+30%Premium <br /> ( ) Other,Note In Special Instructions Section MARKING 0f9 ( ) Same Day SR+50% <br /> HIGHLIGH7ING: <br /> Sample ID Lab ID Collection Matrix Notes or Sample Map, Etc. <br /> Date <br /> D �l _ k Solid <br /> Solid , <br /> Solid <br /> By my signature below i attest that this sample was collected In accordance with KIS'sample directive S013#1-13 or. y other regulatory compliant maanr- <br /> Reiinqu Dale Received By Date l <br /> &TIm &Time '` <br /> e'inquished By Dale Received By Date <br /> &Tune &Time <br /> Relinquished By Date Received lay- Date <br /> &Time &Time <br /> Send Sample To- Enviro-Chem, Inc. Laboratories <br /> 1214 E. Lexington Avenue <br /> Pomona, CA 91766 <br /> Pig- 909-590-5905 <br /> Fax: 909-590-5907 <br /> CA-DHS ELAP Certificate 01555 <br /> C WI5 DOCStRecyelnt$Dws%CcClO9M2R-e I_CoC-Staidvd dce <br />