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rurueum r$SiPtr11@rEC3, 78CramentD 111I11lI111�1111111IIl11111111111111111lIII11111111111 �� <br /> 880 Riverside Parkway Chain of Custody Record �urofinsIirc nnrent iF•s:ii,y, <br /> West Sacramento, CA 95605 <br /> Phone,916.373-5600 fax:916.372-1059 <br /> Sampler Cab PM Carnet Tracking Nor s) COC No <br /> Client Information Sub Contract Lab Evans,Lauren R 320-203105.1 <br /> Omni Contact Phone E-Mae Stale of Ongrn Page <br /> ShippinglReceiving Lauren.Evans@Eurofinset.com California Page 1 of 1 <br /> Company. Accreddations Required ISee note)- Jots R: <br /> TestAmerica Laboratories,Inc. State-California;State Program-California 320-67359-1 <br /> AddressClue I7nte Requested. Preservation Codes: <br /> 3355McLemoreDrive. 1219/2020 Analysis Requested <br /> A,HCL M-Hexane <br /> Gly IAT Requested Idays): F NaDH N-None <br /> Pensacola C-Zn Acetate Q-AsNaO2 <br /> Slate,Lp U Moo Acid P-Na204S <br /> FL.3251A v NaHSO4 0-Na2So3 <br /> Phone pD# j MvOH R-Na2S203 <br /> 135D-474-1 ao1(rel) 850-478-2671(Fax) is AmrJdor S-H2$Q4 0 - H Ascorbic Acid T-TSP Dodecahydrata <br /> Email' Wo# a — Ice V-Acetone <br /> a o m J 01 water V-MCRA <br /> ° H o K EDTA w-pH 4-5 <br /> prosect Name r"olect#. } `o c I EDA Z•othef[spaGfyy <br /> 7-11 No 2D632(CA) 32014426 m °° 2 <br /> a c <br /> Site ssows 0 u Other <br /> w v <br /> Sample Matrix a d <br /> Type <br /> Sample (C=comp, ..";,. m .a <br /> Sam to identification-Client ID Lab ID) Sample Date Time G rats) r,f=ii...i.n-a, UB a r- S ecial InslntcrionsiNote: <br /> Preservation Code: XX I <br /> 10:27 1?-Jul <br /> D-1-4[320-67359-1] 1211120 Solid PaPacificX 1 <br /> cD 10:41 11-Jul <br /> w D-2-4(320-67359-2) 1211120 Solid X i <br /> v P cific <br /> p TP-1-14.5(320.67359-3) 1211120 10:34 Solid X 1 5t-Jul <br /> Pacific <br /> 0Pacific <br /> p TP-2-14.55 320-6735 4) 1211/20} 10:45 Solid X 1 11-Jul <br /> TP-3-15.5(320-67359-5) 1217120Pacif0' Solid X 1 44.023-0 <br /> ic <br /> TP-4-15.5(320-6735") 1211120 11:07 Solid X 1 11'Jul <br /> P it <br /> P-1 4(320-67359-7) 1211120 11:23 Solid X 1 1 t Jut <br /> Pacific <br /> Note.Since Iabpral ry accreditauons ere Subpact to change,Eurains TestAmerica places the ownership of method.analyte 3 a[Credltatenn Ampllance upon out subconuacl laboratories This sample Shlpmenl iS rdrwarded under chatn•et-custody If the labdr®tery does not currently <br /> maintain acreditation in the State of Origin h5ted adore for a rtalysmItestvMatnx being analyzed.line samples must he shipped back to the Euroflns TeslAmerica labciiatory or oMer instruclions roil be provided Any,changes to accmditallon status should be brought to Eumfins <br /> TostAmenca attention Immediately If a I requested accred-10ons are current to dale.return the signed Chain of Custody atlesmg to said�plrtance tp EuroRns TestAmenq <br /> Possible Hazard Identification Sample Disposal(A fee may he assessed ref samples are retained longer than 7 month) <br /> Unconfirmed I 0 Return To Client 173 Disposal By Lab Archive For Monlhs <br /> Deliverable Requested:I,II,III,IV,Other(specify) Primary Deliverable Rank:2 Special InstrectionslCC Requirements: <br /> Empty Kit Relinquished by: pale: Time: _P08406 Of shtpmem <br /> Raltnquished Da Z_ Company Received by <br /> Relinqum y: 0alefTlme: Company Received by. ) Datalrime Company <br /> NRelv,quished by Dalcrrlme. Company ftecelred by Datelrime Company <br /> Custody Seals intact: Custody Seal No.. C.00mr Tamperalure(s)'eand inner Remarks �. <br /> N Ver:i 101+2020 <br /> dCD <br />