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Eurofins TestAmerica, Sacramento <br /> 880 Riverside Parkway Chain of Custody Record eurofins Ee vin, <br /> West Sacramento, CA 95605 <br /> Phone(916)373-5600 Fax(916)372-1059 <br /> Sampler Lab PM Canner Tracking No(s) COC No. <br /> Client Information Devon Owens Cisneros,Roxanne <br /> Client Contact PhoneE-Mad Page <br /> Pat McConnell (408)656-6326 roxanne.cisneros(c)testamericainc.com Page i of <br /> Company: Job# <br /> Stantec Consulting Services,Inc. Analysis Requested <br /> Address Due Date Requested: Preservation Codes: <br /> 9665 Granite Ridge Drive Suite 220 <br /> City. TAT Requested(days): A-HCL M-Hexane <br /> San Diego C-ZnOAcetate O-AsNa02 <br /> State,Zip Standard D-Nitric Acid P-Na204S <br /> CA,92123 E-NaHSO4 O-Na2SO3 <br /> Phone PO# F-McOH R-Na2S203 <br /> tody H <br /> 858-633-4222 NON ENFOS;Invoice Stantec AP/cc P.McConnell G-Amchlor S-H2SOa <br /> Email. WO# i m 320-59971 Chain of Cus -Ascorbic AcidU T-TSP Dodecahydrale <br /> a I-Ice -Acetone <br /> Pat.McConnell@stantec.com o 'o a J-DI water V-MCAA <br /> y Z w K-EDTA W-pH 4-5 <br /> Project Name Project# m m <br /> } o a — L-EDA Z-other(specify) <br /> 7-Eleven Store No.41531 (1046254) 185850913 m o a <br /> Site SSOW# n �, m m Other: <br /> 3379 North Tracy Boulevard,Tracy,CA N o 6 <br /> Sample Matrix m`m u m o C E <br /> Type (w ,r.r. o o <br /> LL K Z <br /> Sample (C=comp, oss�a�aol = m <br /> Sample Identification Sample Date Time G=grab) BT=Tlseue.A=Air) LL CIL H I Special InstructionstNote: <br /> N <br /> Preservation Code: I I I <br /> G S <br /> W I <br /> 1.30 G S <br /> - ! 13✓ G S t 1c 1J1 <br /> g O G S C (-jam 1 <br /> G S <br /> 5 3 3 c; to)L& G S <br /> 5 3 -?i - 10 001.1 L G s 5L i/C l <br /> 53p -�l -t � �'l � G S <br /> is G S <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> `'`Non-Hazard Flammable =Skin Irritant =Poison B =Unknown Radiological =Return To Client [;Z'Disposal By Lab Archive For Months <br /> Deliverable Requested:I,Il,III,IV,Other(specify) Special Instructions/QC Requirements: <br /> Empty Kit Relinquished by: Date: Time: Method of Shipment <br /> Relinquished by. Date/Time: Company I Re rved by Daterrime. Company <br /> Relinquished by. Dale/Time: Company Received by. Datel-rime. Company <br /> � <br /> co Relinquished by Daterrime Company Received by Datefrime Company <br /> N <br /> CD Custody Seals Intact: Custody Seal No. Cooler Temperature(s)°C and Other Remarks I C <br /> CD 1 Yes .% No 11 <br /> Ver:0 1/16/2019 <br />