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'-Pace Uu�11� <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 /> )I Yes [I No If no,matrix description: <br /> County <br /> ❑ Alameda ❑ Contra Costa ❑ Humboldt ❑ Lake ❑ Los Angeles* ❑ Marin <br /> ❑ Mendocino ❑ Monterey ❑ Napa ❑ Orange* ❑ Riverside* ❑ San Bernardino** <br /> ❑ San Francisco ❑ San Mateo ❑ Santa Clara ❑ Santa Cruz ❑ Solano <br /> ❑ Sonoma //❑ ,Tr__ini__ty _ <br /> Other(specify): ` f\ltSII��s ��J✓V \ <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: n�,4-e <br /> Lab ID (if applicable): <br /> Are Samples Regulated? TNo ❑ 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 PPQ530 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 1 <br /> 2/12/20 <br />