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HomeMy WebLinkAboutDEQ-CFW_00071324TestAmerlca Denver 4955 Yarrow Street ± Arvada co Chair~ of Custody "Record, Phone (303) 736-0100 Fax (303J 431-7171 i TesJtca rHT � TAifC.q. �N rsyy�o�isvrte7At. TT'76TINC. sampler. CifgD# Infnrtttatiota C) 1 C� 1(� f' Lab PMtj �� I' Johnston, MiChgile Gamer Vackino "s)r GQC Np:' Ck"I co tod: W. fuGchaei AUcoin bona r; 3 F^AAadiE ro '�7 7 Mich@ilea hnsfon@testamericaioc,com page, g Of The Chemours`Company, C. LLC' - Mel 9is Requested: Job x; Address: 610 AECOM 4051 091elown Road. Suiie 300 Due tote Requested:. Preservation Codes:' '• A HCi. M •:He ane; TAT Requested C+�mJ: 33 -:l Newark i 10BnSfnessDays. ... t v a NaOH N:None'... C- ZnAcolate 0-AsN302 Q Nibk Ack! P » Na2048 stale. DE, 19713' C • NaHSO4>: 0 - Na2S03> F- McOH"' R.-'Na2S2S03 LBI 302,7. 302.781.5873 L@10.67C)481Ei4202000 2231 C151000 j F_•. r� y�• (a-AmChltlq' S-H2SOa, H A.c rft A�i6 T -15P Dodecat ydratr Enrait wok mlChat l:autoin aeGam,GOm I ' Ito`" U:ncero,e Jr 01 Wot4N'1" V . MCAA K EDZ4 - w . ph 4•S Prowl Namc: Prc}ectiL'- FAY-NC-DWRHFPO-DASampling 28016914 Q oT `v ; L-FDA`., z=ahrlspecry" gttrer:= Vte:, ssows w Spmpie Type Sample (C-Ctlmpr o:.:anuw. OtL: Sam"letdetAifiesdon Sa .teDate Tlrne G rab erreis,A.Ar z ' lallnst 5 ructions/Note: ow � r'� i t ^ V I LL ' a Possible Hazard ldentl/icaNan Sample Disposal A fee may be as sassed H samples are retained longer than- 1: month) �(Ski nt'©Poison 6, �: Unkiyown` ©Radio rcal. k Refur of r" To Chertf t7isAosai By Lab Deliverable R quested,1,l'mmery Olher ) Lev Archive For" Months Special tibnstgC Requirements, Empty tit 11611rquished by; r� , sat„ d.' : ... Gate; Timer _ Mon,ceossnapm,nt:: .� ... f Refinquished by: (� cater ane: L� company. a ad by.. ,. ^•,•�,,,,,_,•, _...--• Dale1T' . ,r C{rany o_m " �7 ReNnWeshed b , Da1elrnTfs: .. ... Gp!nVeny Da r ';,...` Company ReImtTl,li9he0 by' � OataTkna: - company any ReeoirndbY% Custody Seats Wact* lCustody Seal No.: w Cooler Tompenture(s) °C and Meraommtt, .Yes__A No .. _..........._._w...:.:.,.,,...w...-.,•.,...�..vv...n-:.a+.nbw w.• �,vww.:,ew7e4uMw'�Rr-'sfwwWY�t7rvr, •, . _. :. 1».:a,:,ex!.�R TestArnerka Denver' . Chaln' of° Custod Re 4855 Yarcow.SVeeL " Y Coed � Arvada. CO 80002; �, 4 1 i171 YHT. r,T ♦O/'q'rM �NVP+QNNMTAtYF�.SY/MCt,• GOC Noa. Phone (303) 73Cr01 Fax (303) 3 - Sampler u� ` n Lab PM., Carrlm Traok ng Nojst: Cllettt IhforinaN Johnston. Michelle Paoe:,. . Page of ctemcenlaa , Phonei' ' Rr - we -� 7Y, jo on@ ricalne,eom' mY heite. hnsl iostame Mr. Michael AucoMi JOR iP'p , a 1Ctiemoura Company FC. LlC _: Anal la, Re 'es u rho .;... , a Aft— Out Oste Requested: � } ' res rvation Codes P ` ; P e ' d Bufte 300 clo AECOM:4051 I eiown Road, ne Gur 10 Business D e.•I7Jna ACllle , o�A�aN OZ Newark73D; .`. { D'- Mldc AM F? -- N01045! \; ,.. .. OE, 19713' "> -.: * 4 F -moo" C A" u, R Ns7.5PS r- s -H260� Pncma: 302.781.5873 LBIO 670481fJ4202000 22 31Q51000 �: f `` H - Ascorbic Aoki T : TSP Dodoaml�ydrare, .. .. WQ -`� 1- ICe J -Dl Water - u - Acekma, V- michael aucol aecom:WmC i K • EQTA W - ph d.$ NOnte' Protest ,_.. L - FDA z olhor fspocyl FAY-NC-DWRHFPO-DASamp1i 't,. 280169141 .",: t� otnsr J - semplo Matrlx , N Wentiflcatlon - SaMplie Oats Sample, (C-comp, Time. C; rsb er A.Ak i . ^1 7"rr 0 " 1, l i Ct +a f i i„ • As9 1J Y r, l ,280 Custody, 98888 Chain of • .... ., /Ur .�. s. I z -R G�i~1 . p il7l, l LJ rlr 9/ .r , N' • / f le F/azard ld6y►HNcadon"assessed!Q "le p1 I fee meYO mpfas ai�e reA rchi longer th an 1 mol(h) r 4i you Hazerrd, Flaoon � Skln lrrrtaM � PoJson 8 � Unknown "© Radfo vca! � , Ts?al eA (� ,. � Oe "c D/el/ tab Archive For Months, (spa,cfy)LevelNbeNverable. Requested I, II;pl, IV., Other „• .., .,. InsrukmWQC,Requrements:;. „.. 0 Em Kit Rel In4 ulshed date. 2 " tima;9' 1. SNpmartt� kr„nmd or m enore ap b C.,snYp - ©5 , Oa1en'me- - :anenv1 - b . : Oa ke, Camvany 1 I RMrnev�tlOC bY: . , -. . OaWXSma• ., ,. r%ul!!Vi TI" ., Raoelwd by;};. ;•. ,. '` Detel7krwf�, Compiny".N 1 O Cus1 Seels Intact Custody 5ba1, No _ Cooler Te(s 'C sna cmra Remarks 1:• all „ � e,Yeallo :7 ccnn i