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State of California <br />PAUXWA Eniogiamental Protect on Auemw <br />Department of Toxic Substances Control <br />our me <br />Page 12 of 20 <br />ENVIRONMENTAL CHEMISTRY LABORATORY 1. Authorization Number <br />ECL No.: bf.OW(0$ <br />SAMPLE ANALYSIS REQUEST <br />2, page <br />O(O <br />Took of <br />3. Requestor.(to Receive Results) a. Name: TrevorAntlerson <br />4. Project Name (if applicable): <br />b. Address: 8800 Cal Center on,. <br />seeal nu„em) <br />Sacramento, CA 95826 <br />Stockton Propeller. Inc. <br />S.TAT Lava l: 2 <br />khY. ua.. zrot <br />c, Phone: (916) 8453634 prsaccas a,sq d. Fax: o—.,iswn) <br />e. Email: tievivanderson @dtse.ca.gov <br />6. Sampling Information: a. Date/time Sampled: 06/03/21 (mm/dd/yy) 7.Cedes(W.ilhmndro Wm Ia. rAlmM <br />b. Location: EPA ID Na. NlA (#:zl#AWPM) a. Unit <br />.,.auo,e.mo,n in..,asaw,pse,y <br />Site: Stockton Pwicallao Inc. <br />b. Project to DVC91524248 <br />Address: 2478 Wilcox Road <br />(—in, x , c. AUivity ID 36322 <br />Stockton, CA 95215 (a, nms. apl it MPC O/A <br />GPS-LaL GPS -Long: e. Count 39-- <br />GPS -Alt: y San Joaquin <br />GPS -Depth: <br />8. Samples: <br />a.10 b. COIICollector'sit.f. Number of <br />Container Size Collector's No. c. ECL No. . Matrix 8. containers Preservative / Field Information <br />Sa- I ODA Q f u..,a <br />2 oiv 32az 1 Te <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />9. Anal is Re treated: Enter sample IDs and sem le ID ranges separated <br />by commas. For exam le,1-3, 5.7, 9 <br />a.lno ani, Anal sis $am le s)ID <br />b.Or ante Anal is Sam to s) ID <br />9 <br />Metals Scan (ICP -AES. 6010C) ) <br />E <br />WEMetals(do WETregardless) ( <br />L <br />PH for Liquid gl)40B or 9040C)D <br />f <br />Other Metals: Chromium Vi <br />C. TCLP Anal sis <br />d.Other Anal is <br />Metals (do TCLP regardless) <br />ie„viol �� ��♦Nr <br />Q. Comments for Multiphasic SampleelAnalysis Priority: <br />10. Analysis Objective: Waste Classi6cstion <br />11. Detection Limit Requirements: <br />12 -Supplemental Re uests: Enter aam le IDs as described in Item 9 <br />Desired Anal sis Sam les ID <br />13. ECL Lab Remarks: <br />L <br />E <br />Initials <br />L <br />Date <br />e <br />14. Chain of Gusto <br />Name Title i alum Inclusive Dates of Costod <br />a'Cr0.� p(sdt/6M $(, �JSJ• §ue/'htT <br />C151i L1 to 6/4 <br />b/Eb[) <br />. r7Bd6fSl#Ne.d-4a., 5AV. s„e,.,�" <br />c ItY ICI 1. )/?.r2! to <br />d. to <br />0 <br />e. ro c <br />f to <br />9 to <br />07.0148,00.,o 12 ", 7 A,m,ved t _ <br />our me <br />Page 12 of 20 <br />