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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
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EHD - Public
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O Y, McCampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br /> W TURN AROUND TIME: RUSH�' 24 HR E1-!4S HR E1172 HE E1.5DAY UI/ ❑ <br /> 1534 Willow Pass Rd. /Pittsburg, Co.94565-1701 <br /> www.mccampbell.com/ main@mccompbell.com GeoTrackerHDFO. PDF❑; EDD❑; write0n(Dv)❑i EQu1S❑ <br /> Telephone: (877) 252-9262/ Fax: )925) 252-9269 <br /> Effluent Sample Requiring"J"[lag[] UST Clean Up Fund Project 0;Claim# <br /> Re ort To: Bill To: Analysis Request <br /> Company: v^. <br /> CL t, r <br /> E-Mail: <br /> Tele: /� Fax: E <br /> Project#: Project Name: e = z I <br /> • Project Location: Purchase Orden# g o ^� u o <br /> Sam ler Si nature: MATRIX METfIOD Po o o m ° > a a N <br /> o = I <br /> SAMPLING PRESERVED w r `' 's <br /> o s c u z a p <br /> Location/ <br /> SAMPLE ID <br /> yield Poin <br /> Name vN.6 <br /> r <br /> -tv <br /> _ �.jy �a 3a 1 X <br /> .7MAI'clientsdisclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate harm or serious future health endangerment as a result ofhrief, <br /> gloved,open air,sample handling by MAI staff.Non-disclosure incurs an immediate 5250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing <br /> us to work safely. <br /> Relinquished By: Date: Time: Received By: ICE/f COMMENTS: <br /> GOODCONDITION <br /> HEAD SPACE ABSENT <br /> Relinquished By: Date: Time: R ceiv By: DECHLORINATED IN LAB_ <br /> APPROPRIATE CONTAINERS_ q Cr— J'7 <br /> PRESERVED IN LAB 1� - <br /> Relinquished By: Date: Time: R iced By: VOAS ORG METALS OTHER HAZARDOUS: <br /> PRESERVATION p1IQ <br />
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