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Eurofins TestAmerica, Irvine III) II II II III I III I I II III II =• <br /> 17461 Derian Ave Suite 100 Chain of Custody Record ( ttrofins <br /> Irvine, CA 92614-5817 <br /> Phone:949-261-1022 Fax:949-260-3297 <br /> Sampler: Lab PM. Carrier Tracking Nola): COC No: <br /> Client Information (Sub Contract Lab) Gonzales,Justinn 440-143213.1 <br /> Client Contact: Phone: E-Mail. State of Origin: Page: <br /> Shipping/Receiving justinn.gonzales@testamericainc.com California Page 1 of 1 <br /> Company. Accreditations Required(See note): Job#: <br /> Aquatic Testing Laboratories State Program-California 440-248216-1 <br /> Address: Due Date Requested: Preservation Codes: <br /> 4350 Transport#107, 8/28/2019 Analysis Requested A-HCL M-Hexane <br /> City: TAT Requested(days): B-NaOH N-None <br /> Ventura - C-Zn Acetate 0-AsNa02 <br /> State,Zip: D-Nitric Acid P-Na204S <br /> CA,93003 E-NaHSO4 Q-Na2SO3 <br /> F-McOH R-Na2S203 <br /> Phone: PO Amchlor S-H2SO4 <br /> c r H-Ascorbic Acid T-TSP Dodecahydrate <br /> Email: WO I-Ice U-Acetone <br /> `o Z o J-DI Water V-MCAA <br /> T m <br /> a C K-EDTA W-pH 4-5 <br /> Project Name: Project#: L-EDA Z-other(specify) <br /> UPRR-Sludge Bin Stockton-New Profile 44014970 „ ro :9 <br /> LL C <br /> Site: SSOW#: E Y r Other: <br /> A O <br /> Sample Matrix m m E <br /> Type (w=..mar. ii € z <br /> s=noad, a <br /> Sample (C=comp, o <br /> Sample Identification-Client ID Lab ID Sample Date Time G= rob) BT=T;nnun.A=Air 'LL n° A r°- Special Instructions/Note: <br /> Preservation Code: <br /> v <br /> COD Sludge Bin-Stockton(440-248216-1) 8/15/19 Pacific <br /> Waste X 1 <br /> Pacific <br /> W <br /> O <br /> O <br /> W <br /> N <br /> Note*Since laboratory accreditations are subject to change,TestAmerica Laboratories,Inc.places the ownership of method,analyte&accreditation compliance upon out subcontract laboratories. This sample shipment is forwarded under chain-of-custody. If the laboratory does not <br /> currently maintain accreditation in the State of Origin listed above for analysis/tests/matrix being analyzed,the samples must be shipped back to the TestAmenca laboratory or other instructions will be provided. Any changes to accreditation status should be brought to TestAmenca <br /> Laboratories,Inc.attention immediately. If all requested accreditations are current to date,return the signed Chain of Custody attesting to said complicance to TestAmerica Laboratories,Inc. <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> Unconfirmed 0 Return To Client =Disposal By Lab Archive For Months <br /> Deliverable Requested:I,II,III,IV,Other(specify) Primary Deliverable Rank:2 Special Instructions/QC Requirements: <br /> Empty Kit Relinquished by. Date: Time: Method of Shipment: <br /> Relinquished by Da ime. Company Received by Date ime: Compan <br /> I I& �t G3G L <br /> Relinquished by Dat4fTimle. k Company Received by: Date/Time: Company <br /> 00 <br /> 00 Relinquished by. Date/Time. Company Received by: Date/Time: Company <br /> W <br /> O_ <br /> NCustody Seals Intact Custody Seal No.: Temperatures)°C and Other Remarks: <br /> O tt : ClT � �_— <br /> � es � No <br /> O <br /> Ver-01/16/2019 <br /> L <br />