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277g9 aceAnalytical <br />NaPuna, Gen loshng t•.+L.‘ehv <br />CA Regulated Soil Notification <br />Any soils received without this completed form cannot be receive or processed until <br />the site address is confirmed. <br />USDA / APHIS regulates material with organic matter, including soil, from specific <br />counties that have invasive species, pests, or plant diseases present in the county. In <br />order to process your project, we need to determine if special handl ng applies to your j <br />project. <br />Receipt of Soils from California: <br />Are samples soil or other regulated material? <br />Yes El No If no, matrix description: / <br />County <br />CI Alameda 0 Contra Costa 0 Humboldt 0 Lake 0 Los Angeles* 0 Mann <br /> <br />CI Mendocino 0 Monterey CI Napa 0 Orange* LI Riverside 0 San Francisco <br />0 San Mateo 0 Santa Clara 0 Santa Cruz 0 Solano 0 Sonoma CI Trinity <br />Other (specify): v.. t—A---L <br />(If soils are from one of the 18 counties specified above, the site address is required.) <br />Site Address: <br />Fire Ant and '• Fruit Fly quarantines may be partial county quarantines. The site address must be checked against APHIS interactive maps to <br />determine if the site is within the quarantine area. <br />To be completed by Pace National: Client:12 <br />Lab ID if dppli(Ale) <br />Are Samples Regulated? 9( No 0 Yes <br />Regulated for? 0 Phytophthora Ramorum 0 Fire Ants 0 Fruit Flies** <br />Amount of soil received: - grams <br />Received on: <br />Will any analysis be done at another lab? 0 Yes 0 No <br />If yes, complete the following for each lab that will receive the regulated samples: <br />Receiving lab notified soils are regulated? Shipment <br />Receiving Lab Amount shipped sent with receiving lab's Compliance Agreement? <br />Yes (initial / date) <br />Yes (initial / date) <br />Yes (initial / date) <br />Yes (initial / date) <br />'• Soils cannot be transferred to another destination without a PPQ 530 form. Contact Jordan Krui at Jordan.d.kru @aphis.usda.gov. <br />Initial / date after a copy of form has been sent to Anthony Jackson, USDA APH S PPQ <br />HAQAQC\Public\Controlled Docs\DAV-31 CA Regulated Soil Notification.docx DAV-31 <br />Rev 2 <br />7/17/20