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SR0081488 SSNL
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2600 - Land Use Program
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SR0081488 SSNL
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Last modified
11/20/2020 2:57:34 PM
Creation date
2/19/2020 2:05:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0081488
PE
2602
FACILITY_NAME
10966 E MARIPOSA RD
STREET_NUMBER
10966
Direction
E
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18106009
ENTERED_DATE
12/4/2019 12:00:00 AM
SITE_LOCATION
10966 E MARIPOSA RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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General COC MAI Work Order# 1 2— <br /> McCAMPBELL ANALYTICAL, INC. <br /> CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd,Pittsburg,Ca.94565-1701 Tum Around Time:l Day Rush 2 Day Rush 1 3 Day Rush I STD • 1 QUoteµ <br /> Telephone:(877)252-9262/Fax:(925)252-9269 1-Flag t MDL ESL Cleanup Approved Bottle Order# <br /> www.mccampbell.catn main a�mceatl�pUell.com Delivery Forma(: PDH GcrTrackc7 EDF EDD Write On(DW) EQu1S <br /> Report To:Tamara K.Woods Bill To:tkwoods@terracon.com Analysis Requested <br /> Company:Terracon Consultants,Inc.,902 Industrial Way,Lodi,CA 7 <br /> Email:tkwoods@terracon.com 0p Cf) <br /> Alt Email:tamara.woods@terracon.com Tele: 209-269-8586 tY) b <br /> W N <br /> Project Namc:Arriaga Property Project#:NA187059 t LO <br /> Project Location:10966 E.Mariposa Road,Stockton,CAPO# Z W <br /> Sampler Signature: �t ' CU t <br /> Sampling G U <br /> SAMPLE ID Matrix Preservative m O <br /> Location/Field Point Date Time <br /> Z f� _ <br /> GW1 GW • <br /> GW2 (1 of 2) , 1 GW Ascwblc/hteleic <br /> GW2 (2 of 2) 4-1;0f 1 GW AswrbWklelm <br /> Trip Blank 2 GW • <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,gloved,open air,sample handling by MAI staff. <br /> Non-disclosure incurs an immediate S250 surcharge and the client is subject to full legal liability for harm suffered.Thank you for your understanding and for allowing us to work safely. <br /> *If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will default to metals by E200.8. Comments 1 Instructions <br /> Please provide an adequate volume of sample.If the volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared in its place and noted in the report. <br /> Relinquished By/Company Name Date Time Received By,/Company Name Date Time <br /> r )i <br /> Matrix Code:DW=Drinking Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S=Soil,SL=Sludge,A=Air,WP=Wipe,O=Other �. <br /> Preservative Code: 1=4°C 2=HCI 3=H2SO4 4=14NO, 5=NaOH 6=ZnOAc/NaOH 7=None Temp 11C Initials <br />
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