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aceAnalytical' <br /> CA Regulated Soil Notification <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 handling applies to your <br /> project. <br /> Any soils received without this completed form cannot be received or processed until <br /> the site address is confirmed. <br /> Receipt of Soils from California: <br /> Are samples soil or other regulated material? <br /> ❑ Yes fA No If no,matrix description: 5 ( 1+- <br /> County <br /> ❑ Alameda ❑ Contra Costa ❑ Humboldt ❑ Lake ❑ Los Angeles* ❑ Marin <br /> ❑ Mendocino ❑ Monterey ❑ Napa ❑ Orange* ❑ Riverside* ❑ San Francisco <br /> ❑ San Mateo ❑ Santa Clara ❑ Santa Cruz ❑ Solano ❑ Sonoma ❑ Trinity <br /> Other(specify):50-fl— 13 <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: 0 rv,ort <br /> Lab ID(if applicable): <br /> Are Samples Regulated? 7 No ❑ Yes <br /> Regulated for? ❑ Phytophthora Ramorum ❑ Fire Ants ❑ Fruit Flies** <br /> Amount of soil received: " grams <br /> Received on: <br /> Will any analysis be done at another lab? ❑ Yes ❑ 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 /> g Yes (initial/date) <br /> g Yes (initial/date) <br /> g Yes (initial/date) <br /> g Yes (initial/date) <br /> '•Soils cannot be transferred to another destination without a PPQ 530 form. Contact Jordan Krug at Jordan.d.krug@aphis.usda.gov. <br /> Initial/date after a copy of form has been sent to Anthony Jackson, USDA APHIS PPQ <br /> H:\QAQC\Public\Controlled Docs\DAV-31 CA Regulated Soil Notification.docx DAV-31 <br /> Rev 2 <br /> 7/17/20 <br />