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Eurofins TestAmerica, Sacramento <br /> t'LI f�]f S f15 <br /> 880 Riverside Parkway <br /> Chain of Custody Record <br /> West Sacramento, CA 95605 <br /> Phone[916]373-5600 Fax(9 16)372-1059 <br /> Sampler Lab PM Carver TrarA,ng NoW coc NO <br /> Client Information Richie Winn Evans,Lauren <br /> Client comas Phone E-Mail: Page: <br /> Pat McConnell 1(916)717-2353 iLauren-EvansaEurofinset.com Page t of <br /> Company Jots is, <br /> Stantec Consulting Services Analysis Requested <br /> Addrass Due Date Requested: Preservation Codes- <br /> 9665 Granite Ridge Drive Suite 220 s A-NCL M-Hexane <br /> City TAT Requested(days): 6-NwUH N-None <br /> Sen Diego D-Nitric Acid P-Na204S <br /> State.Zip: Standard <br /> CA,92123 _ F-mom R-Na2SOo3 <br /> Ptione. # G•Amchiar S-H2SO4 <br /> 858-6334222 NDN ENFOS:Invoice Stantec APfcc P"McConPei l x H-Ascorbic Aad T-TSP Dodecahydraie <br /> Email Won v o I-.Ice U-Acetone <br /> Pat"McConnell@stantec"oam <br /> Y '� E J-01 W alet V-MCAA <br /> n rn <br /> Pmtect Name: Project#: v `o c K-EDTA W-pH 4.5 <br /> 7-Eleven Stare No.20632 185850910 n } ? L-EDA Z-other ispecrfy) <br /> Site: SSOW# E °u 011ier' <br /> 4627 Da Vinci Drive,Stockton,CA rn u m O A v <br /> a m r 0 v <br /> Sample Matrix o in 2 pa 4 E <br /> Type <br /> Sample tC=comp, 04 x, r = F 5 ecia]knstructianslNote: <br /> Sam le Identification Sample Date Time G= rah er.n..w,••u, ua q- LL e'- ° <br /> M <br /> N Preservation Code: <br /> Cl) <br /> o ?P <br /> TT <br /> r? <br /> C,—1 -- 1113 X If, X <br /> + <br /> I <br /> 1 <br /> f <br /> 320.57359 Chaln of Ctrslad) <br /> Possible Hazard Idearli+callon Sample Disposal{A fee may be assessed it samples are relafnea longer than}month) <br /> 1=1 Non-Hazard 11 Flammable Skin bill.. Poison B 1� Unknown 1=1 [tad' lcal =Refurn To Client Disposal By Lab © Archive For Months <br /> Deliverable Requested I,11,III,IV,Other[specify] Special InslructionsICC Requirements: NO EDF REQUIRED <br /> Empty Kit Relinquished by: Date: Time: Method or sh,pmem: <br /> Refirxtulshed by DataiTima Company Roomed byDaterrmns Company <br /> L <br /> "rA - f�f 1�Ccr�p +���I :.3:fF' •G ^ — tZi i I"vv ��.t 4..1 F-'jlt�f[{ <br /> Relinquished by: DalaTime: Company Received by DalelTime Company <br /> N <br /> O <br /> Rolinq+Jished by: Dale!rlme Company Received by Dalemme Company <br /> N <br /> O Custody Seals Intact: Custody Seal No. Gooier Temperature(st`c and other Remarks: <br /> CD A Yes A No <br /> Ver 01 16:2019 <br />