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Jin 18 2007 2:31PM HML-SAMPLE-TRACKING OFFIC (510) 849-5271 01/18.2007 10:11 F.A-1 918 255 3897 — DTSC/SAMA 11ENTO 0001 lment of Toxic Substances Control SUPPLEMENTAL ❑ Environmental Chemistry Laboratory icnR n �uawe rntai arc z rrl, AUTHORIZATION REQUEST FORM (ARF) PART A: (By Requestor - PLEASE PRINT) TAT Level: 211- ❑ 2 ❑ 3 ❑ 4 Requestor's Name Alex Baillle Emall abaillle Qdtsc.a.gov Phone( 916 ) 255-3751 Region 01 -Sacramento Unit HWM -SCD Fax ( 916 ) 3595 Back-up Raqusstor Allan Ito Phone( 918 )_3827_ APZA CODE Site Name Lodi Chrome, PART B: Analytical Requests (By Requestor) (Lab uses default methods listed below. Please speedy all :ffner requests Numbelr of SarrtpleslType I Number of SamoiesfTyp O ani- Ana( sis Solid LJauio Water Othe {nor anis Anal 518 SaUdtiqu Wale Other °S Dry Solids (ECLT30-S) I Acidity (305-1) Alkallnity (310-1) Carbonyl Compounds (8315A)_ Anions by IC (9058) Chromium VI(Cr") by Colorimetric (7195A) Chromium VI(Cr`'))n Waterby IC (7199) Cyanides for Wastas,Learhates (901DS) 5 3 Hartness (130-2) Mercury(Hg)in (Seml)Solld Waste (7471A) Mercuiy(Hg) in Liquld Waste (7470A) Metals Scan (50108, for As,Ba,Cu,Pb, etc) 6 Q liwWais Scan (for'Drinking water, 8020A) r`--anoLead In Waste (ECL938-M) ::Is Size (F -S) PemWorate for Sall.Sludge (ECL955-M) Perchlorate for Water (314-0) pH (90408, 90450) 6 fi Total Dissolved Solids (160-1) ET(ECLQ10-S) o"y!rn,—,- 0.0-' X--. is 6 Colliers, two In) TCLP Anal sis+ Metals Onry+re.o.a.ry 6 6 _ Mercury oats ❑ D.11 –sham Vclatlles oeit it-4so ry13 De it rciardtco san'11YOW11les U Oatr if .ea.aary Do II rag—uca (atner9,tym In) F.1 GRO (Gasoline, 80158) DRO(Diesel) only (ECLB16_M)� Motor Oil only (ECL81fi-M) DRO(Diesel) b Motor Oil (ECL316 M) _ I EthyleneGlyccl (ECL772-M) _^ _ PHDES (ECL7504A) PCBs (6082) Pesticides - Chlorinated (13081A) PasNc(des- Organophosphate (6141 A) I _ 1 4 -Dioxane (ECL630-S) Other Fish Bloassay (Title 22) – Congener PCBS (ECL -CG -PGB) Congener PBDEs (ECL-CG-P9DE: Analysis Objective: Waste Characterization Detection Limit Requirements: (Check ECL Users Manual to assure detault OL Is sufficient.) orner cornmantac Expected Date of sample Arrival at Lab 01/17107 (mmlddryy) PART C : (By SMO - ECL) / Q ARF's Revision No. Aurhorizallon Number (AN) Q G Initials: Date: Lab to Receive Sampie(s) Thi :c � - l jv PRFs RevisfonPla_ _ Initials: Date: Sample Management Officer (SMO) ��/^ ❑ Check box if cancelled Initials: Date: Today's Date ( ( (rnmlddlyy) Expiration Date 1 I�_ Q� (mmidd'yy) TAT Laval, '1 = 10-15 days (requirPS unll onlefe signature crt SARj 2 = 1e - 3e days 3 = 31 - 45 bays 4 = wr.en pasSitte -'TCLP .11 y.ne parmitb ana asrr,ple matrix type is appropriate, lab may anallae at screen the samples) first to determine it TCLP is needed. ECL01 (REV 1010e) Semivolatiles (827DC) I Volatiles (8260B) Carbonyl Compounds (8315A)_ HPLC Explosives (8330) PAHs (83 10) _ DicAns/Furans by HRGC)HRMS (ECL880-M) ! _ Flash Point 1024A n -Hexane Exlraetabies/TPH (1664) TXO-Total Halogens in Oil (ECL792-S) Other Fish Bloassay (Title 22) – Congener PCBS (ECL -CG -PGB) Congener PBDEs (ECL-CG-P9DE: Analysis Objective: Waste Characterization Detection Limit Requirements: (Check ECL Users Manual to assure detault OL Is sufficient.) orner cornmantac Expected Date of sample Arrival at Lab 01/17107 (mmlddryy) PART C : (By SMO - ECL) / Q ARF's Revision No. Aurhorizallon Number (AN) Q G Initials: Date: Lab to Receive Sampie(s) Thi :c � - l jv PRFs RevisfonPla_ _ Initials: Date: Sample Management Officer (SMO) ��/^ ❑ Check box if cancelled Initials: Date: Today's Date ( ( (rnmlddlyy) Expiration Date 1 I�_ Q� (mmidd'yy) TAT Laval, '1 = 10-15 days (requirPS unll onlefe signature crt SARj 2 = 1e - 3e days 3 = 31 - 45 bays 4 = wr.en pasSitte -'TCLP .11 y.ne parmitb ana asrr,ple matrix type is appropriate, lab may anallae at screen the samples) first to determine it TCLP is needed. ECL01 (REV 1010e)