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2900 - Site Mitigation Program
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PR0538738
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
2/6/2020 2:19:48 PM
Creation date
2/6/2020 9:21:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0538738
PE
2950
FACILITY_ID
FA0022243
FACILITY_NAME
NEIL O ANDERSON & ASSOC INC
STREET_NUMBER
902
STREET_NAME
INDUSTRIAL
STREET_TYPE
WAY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
902 INDUSTRIAL WAY
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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OG McCampbell Analytical, Inc. <br /> CHAIN OF CUSTODY RECORD <br /> �G1534 Willow Pass Rd./Pittsburg, Ca.94565-1701 TURNAROUND TIME:Rustle 2a HR Q48HRp�z HR [:1!5 DAY ao DAY ❑ <br /> www.mccompbell.com/ main@mccampbell.com GeoTmcker EDF❑j PDF❑I EDD❑J Write Oa(DW)❑j EQuIS❑j <br /> Telephone: (877)252-9262/Fax: (925) 252-9269 <br /> Effluent Sample Requiring"J"Dag O; UST Clean Up Fund Project 0,;;Claim# <br /> Re ort To• 0 S e Bill To: (yeii Q, Anal sis Rennes <br /> Company: ut m <br /> E-mail: NSSP(PS' <br /> S o pC y o <br /> Tele: _ Fax: CL601 ) 111.8 -6314i <br /> r. u <br /> PWYwr�oz3�jea�pac--tss-l�#'iII:` <br /> Pro <br /> jecia.t NaOame3aA`: dX=:Ln' OPrQ.. yf aOLL <br /> XXxo_Fa <br /> a <br /> v e <br /> Project LocaPurchase Order# r 0 ySam lerSi nature: SAMPLING MATRIX METHOD m v <br /> PRESERVED <br /> SAMLE ID Location/ <br /> Field Poin e : .. <br /> Date Time Name <br /> U O X <br /> lr 1 <br /> nae5s'- N <br /> Ia u x <br /> wa <br /> �xv <br /> . <br /> t <br /> • <br /> x <br /> **MAI clients MUST disclose any dangerous chemicals I:no,�"to be present in their submitted samples in cancentrotions that may cause immediate harm orserions future health endangerment as a result of brief, <br /> gloved,open air,sample handling by MAI staff.Nondisclosure incurs an immediate$250 surcharge and the client is subject to full legal liability for harm suffered. Thaukyou for your understanding and for allowing <br /> ustoworksafel . COMMENTS: 5 k\ SWFf1r <br /> ReI'nquished By: Date: Time: Received By: ICEtt' - II T <br /> y ?0 �� GOOD C ND ION— 1 Q SCM )O q v✓l L U, <br /> I �Li DEAD SPACE ABSENT_ <br /> Rdin uish` Date: Time: c' d By: ` n DECHLORINATED IN LAB <br /> y, Y1v^Y/ �(�( HiQ 1111it IfQ <br /> APPROPRIATE CONTAINEILS �• dl <br /> PRESERVED IN LAB_ C011 Neil d• <br /> Relinquished By: Date: 7 ITime: Received By: VOAS O&G METALS OTHER HAZARDOUS: <br /> PRESERVATION nHd l <br />
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