Laserfiche WebLink
OC 40 8 a6Pd TestAmerica Pleasanton <br />1220 Quarry Lane <br />Pleasanton, CA 94586 <br />Phone (925) 484-1919 Fax (925) 600-3002 <br />Ch,i&f Custodyco <br />Ii <br />TestAmerica <br /> <br />,Iir I nnrP IN FN,itenNMeNl'Al TrcTtrlfl <br />Client Information <br />Sampler -1' -*Or — Stair lila g IIII. i Carrier Tracking No(s) <br />180-50516-67 54.1 <br />GOC No <br />Client Contact' <br />David McAdams <br />Phone pege <br />Page 1 of 1 <br />Company <br />Calgon Carbon Corporation Analysis Requested <br />mob a <br />Address <br />3000 GSK Dave <br />Due Date Requested: <br />i <br />73 > <br />1 <br />MO <br />i <br />I <br />ri rn <br />g <br />tO 7 60108, 7470A - ICP Metals & Ikibrcury 1 Type <br />- EDA 7- other (specify) <br />,. <br />...' <br />.• . <br />,. <br />.Ii <br />T. <br />t <br />. 8 <br />IS <br />1 <br />§ <br />-I <br />Preservation Codes: . <br />A -HCL M - Hexane <br />B - Na01-1 N - None <br />C - Zn Acetate 0- AsNa02 <br />D - Nitric Acid P - Na204S <br />E - NeHSO4 0 - No2S03 <br />F - Me0H R - Na2S203 <br />G - Arnchlor S - H2SO4 <br />bi -Ascorbic Acid T - TSP Dodecahydrate <br />i - Ice U - Acetone <br />J - DI Water V - MCAA <br />- EDTA W - pH 4-5 <br />L <br />Other: <br />COY. <br />Moon Township <br />TAT Requested (days): <br />5 work day 1 <br />State. Zip: <br />PA, 15108 <br />Phone <br />412-787-4793(Tel) <br />PO a <br />Purchase Order not required <br />Email <br />dinGaGiamsGalgoncarbon.com <br />WO It <br />Project Name <br />Calgon Stockton, Water <br />PrOteCt*• <br />18007073 <br />Site SSOVVe. <br />Sam le Identification Sample Date <br />Sample <br />Time <br />Sample <br />(C=coms, <br />O=grabLerr-www,rok <br />Matrix <br />o....,,,,,,ii, .... <br />S cfal Instructions/Note: <br />'. 'PreOervition‘ q <br />. <br />. <br />3/26:7fo',. it ),.._ -v- 1(zDiA C Water NNX X X <br />I- <br />' e <br />8 <br />i <br />s <br />P <br />e <br />i <br /> <br />PA <br />o <br />l 11111t 5 <br />R <br />4 <br />int <br />Chain of Custody <br />Ill Dpulenla p <br />P <br />o <br />g L <br />Pl <br />b <br />ea <br />, t <br />em <br />b <br />a <br />u <br />ll <br />r g <br />C <br />h <br />O <br /> w <br />C <br />i ltl o <br />D <br />g <br />a <br /> s <br />v <br />a <br />id <br />m <br /> <br />I- L <br />I t <br />Possible Hazard Identification <br />= <br />Non-Hazard = Flammable =Skin Irritant = Poison B = Unknown =Radiological <br />Sample Disposal ( A fee may be assessed if samples are retained longer than 1 month) <br />L = F?eturn To Chant =Disposal By Lab = Archive For Months <br />Deliverable Requested I. it, III. IV, Other (specify) Special Instructions/0C Requirements: <br /> I G <br />Empty Ka Relinquished by: Date Time: Method of Shipment <br />Relinquished by.h ,...e.,,, eivrice",i, p ,? <br />Datierr2706, /1,,,, t i : zoz...4. 04 i <br />' <br />Cocimbein,y r, owbcf Received y. <br />.DAAN gAd2 ,2A-1 Dale/Time r, "2-7-e C "`"PP/ Relinquished by Date/Time Company Received by Date/Time Company <br />Relinquished by Date/Time Company ReCenied by Date/Time- 'Company <br />I— Custody Seals Intact: <br />.1 Yes A No <br />Custody Seal No.. cooler remeerature(s)*C and Other Remarks <br />Ver. 01,i6'211i9