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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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O'a`r McCampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br /> W� <br /> 1534 Willow Pass Rd./Pittsburg, Ca. 94565-1701 TURNAROUND TIME:RusH❑.1 24 HR❑;4g 14R Q.172HR Ojs DAY _ l0 DAY ❑; <br /> www.mccompbell.com/ main@mccompbell.com GeoTracker EDP OI PDFEI' EDDOI Write 0n(DW)❑j EQuls❑" <br /> Telephone: (877) 252-9262/Fax: (925) 252-9269 <br /> Effluent Sample Requiring"d"Bag❑,' UST Clean Up Fund Project 0'.;Claim# <br /> Re ort To: Bill To: Anal sis Request Sc <br /> 0 <br /> Company: <br /> E-Mail: <br /> Tele: I Fax: <br /> Project#: Pro'eet Name: r n z e <br /> Project Location: Purchase Order# <br /> X \ l� _�_L-• �.cl�( <br /> 0 >Sam ler Si nature: 0 yqca a <br /> METHOD UMATRIX <br /> SAMPLING PRESERVED <br /> SAMPLE ID Location/ <br /> Name 2 2 <br /> ca cU Z �emQml <br /> UVMeld Poin Zmoi. 5 <br /> Date Time <br /> 3: b <br /> $c_ Oyqui3`s <br /> ' <br /> O✓��l <br /> k --=T— <br /> - - - --- --- - - --------- [ <br /> ----------- T <br /> --MAI clients MUST disclose 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 of brief, <br /> gloved,open air,sample handling by MAI staff.Non-disclosure incurs an immediate$250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing <br /> as to work safely <br /> Relinquished By: Date: PTime: ed y ICE/t' COMMENTS: <br /> ((q� GOOD CONDITION_ yf� f p• <br /> � HEADSPACE.4BSENT �a/Ili(I tJ (,o$yl Gt"1'�'r DECHLORINATED IN LAB <br /> Date: ei d By: APPROPRIATE CONTAINERSPRESERVED IN LAB_Rcli?'yshed'By: ate: ceived By: VOAS O&G METALS OTHER HAZARDOUS: <br /> �,// PRESERVATION nH<2 <br />
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