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State of California <br />N IT Environmerital Protection Aaencv <br />Department of Toxic Substances Control <br />ENVIRONMENTAL CHEMISTRY LABORATORY <br />1. AuthodzatioTNu.be,ECL <br />ECL No.:2. <br />SAMPLE ANA LYSIS REOUE3T <br />page <br />---of <br />3. RequeateC(M Receive Results) a. Name: TrevorAnderson <br />Project Name (if applicable)b. <br />_. <br />Atldress: 8800Cal Center Drive_ (yStockton <br />Propeller, lnc. <br />Sacramento, CA 95826c. <br />Phone: (918) 645-3634 (.-.defim) d. Fax: (ueTAT <br />Level: 2 <br />e. Email: trevor.anderson @dtsc,ca.gov <br />6.Samplinginforma9on: a, DatatTime Sampled: 06/03/21_ (mCodes (seenrmmeraRacorniinmfinmmepRnueb) <br />b. Location: EPA ID No. N/A (R:Un8 <br />�nvu>.omr,aprmmeilme.oa.mev(s"e1 <br />Site: Stockton Propeller, Ino. <br />_ b. Project ID Dp_SC9152_42-08 <br />Address: 2478 Wilcox Road _ (m,eel,xmiped c. Activity ID <br />_3632_2 _ <br />Stockton, CA 95215 _ (cib. %tee, ap) d. MPC <br />_ _ <br />GPS-Lat:- _ GPS -Lang: e. County 39 -San Joaquin <br />_ _. _ <br />_ _._— - -- _- - <br />GPS -Alt:_ _ GPS -Depth: <br />8. Samples: f. Number of <br />a.ID b. Collectors No. c. ECL No. d. Matrix e. Container Size wntainers . Preservative / Field Information <br />2 _SP- I0A Lail <br />-4—- <br />-5- <br />-6- <br />T <br />9. Analysis Regulated: Enter sample IDs and sample ID ran as ae rated <br />by commas. For exam le, id, 5-7, 9 <br />a. Inorganic Analysis Sam les ID <br />b. O anic Anal sis Sam a s) ID <br />F <br />1 <br />Metals Scan (ICP -AES. 6010C)_ ( <br />E <br />WET Metals (do WET regardless) ( <br />- -_ - - - <br />L <br />_ <br />- - - - - - - - - -. <br />R11kr Llquld(9040Bor9040C). _ _ <br />_ _ _-- - _-' - - ---- <br />D <br />Other: Chromium Vl <br />------ - - - - - - <br />C.na sis <br />d. Other Analysis <br />(do TCLP regardless) <br />ts for Mulrlphasic SamTPles/Analysis Pdodty: <br />is Objective: Waste Classification <br />ion Limit Requirements: <br />.meMal Re oasts: Enter sample IDs as described in Item 9 <br />13. ECL Lab Remarks: <br />Desired Anal sls Sam lea ID <br />L <br />E <br />Date <br />e <br />14. Chain of Custod <br />Name Title i nature <br />4inclusive DeteS of Cuslod <br />�f•fiJ._�aMAST— <br />bTE��jQ�/M•• _ G[{/zaal to wxjaz) <br />—FYh.taaa Hed.Fr... &%v. &,e.s - L <br />'� - - <br />��1� J/2a2J roe. <br />c. - - <br />- <br />_ _- --- - - - __-__ - - _ to <br />c <br />I. - _ _. -- - -._ _ _ to <br />— — to <br />to0]014600 rav0 1Y2 11 AaarovM nv Oumim een��,.o,..e.., ns..e. .._�. <br />ho ccopies for Your File <br />