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SR0080796 SSNL
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SR0080796 SSNL
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Entry Properties
Last modified
5/18/2020 8:55:12 AM
Creation date
11/19/2019 8:29:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0080796
PE
2602
FACILITY_NAME
BERT AZEVEDO
STREET_NUMBER
12110
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00728046
ENTERED_DATE
6/21/2019 12:00:00 AM
SITE_LOCATION
12110 E JAHANT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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General COC MA! Work Order g moiet-fm. <br /> <br />McCAMPBELL ANALYTICAL, INC. <br />1534 Willow Pass Rd. Pittsburg. Ca. 94565-1701 <br />110 <br /> <br />telephone: 1877) 252-9262 / Fax: (925) 252-9269 <br />www.mccampbell,corn Maio@mccampbell.com <br />CHAIN OF CUSTODY RECORD <br />Turn Around Time. I Din Rush 2 Day Rush 13 Da) Rusle-1 STD Quote # <br />1-Flag/ MDL ESL Cleanup Approved Bottle Order # <br />Dellvery Format: POP GcoTracker EDF IT.EZ Write On (Owl EQuISI n <br />Report To: Tammy Woods Bill To: Macy Humphrey Analysis Requested <br />Company: Terracon Consultants Inc. NITRATE AS N - E300.1 DBCP - E524.3 Email: tamara.woods(gterracon.com / macy.humphrey©terracon.com <br />Alt Email: Tele: 209-712-7159 <br />Project Name: Azevedo Property Project k:NA197009 <br />Project Location:12110 E. Jahant Road PO # <br />Sampler Signature: , --,...?"271-.224,"zok..... <br />SAMPLE ID <br />Location / Field Point <br />/..t0:2)64--, <br />Sampling 4 h <br />' Z Matrix Preservative <br />Date Time <br />GW-1 04/17/2019 1030 1 GW <br />GW2 04 /17/2010 1040 2 GW ^.."‘"" _ <br />TRIP BLANK 2 <br />.- <br />---- — <br />NtAi clients MUST disclose any dangerous chemical known to be present in their submitted samples in concentrations that Illay cause immedia charm or serious future health endangerment as a result of brief, gloved. open tr. sample handling by MAI staff <br />Non-disclosure incurs all immediate 5250 surcharge end the client It subject to full legal Ii bility for harm suffered. Thank you for your understanding and for flossing us to work safely. <br />II metals are requested for water samples aneTthc water type (Matrix) is riot specified on the chain of custody. MAI will default to metals by E200 8. Comments / Instructions <br />— A <br />Please provide an adequate volume of sample If the volume is not sufficient torn MS/MSD a LCS/LCSD will be prepared m its place and noted in the report <br />Relinquished By! Company Name Time Received By /Company Name Dare Tame 4.11/Ditpe,j <br />`7:0 1P4-'/A.4/1/1/' / -1 -e ii'v aCcr-, 'j,/ I 1,,.; a il 0 2 _ ,ivi . ( --[R. otc cel l lo'2,- 7,, p <br />, ,:r ., <br />i SI161 <br />=Other <br />)9.---T) <br />\ latrix Codc• OW —Drinking Water, GW—Ground Water, WW—Waste Water, SW=Seawater, = 1 ludge, A=Air, WP=Wipe, <br />Preservative Code: I=4°C 2=HCI 3=1-12SO, 4=HNO; 5=NaOH 6=Zn0Ac/NaOH 7=Nory'e Temp "C Initials •yr <br /> <br />Page of <br />Page 9 of 10
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