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SR0081473
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081473
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Entry Properties
Last modified
3/16/2020 4:52:30 PM
Creation date
3/16/2020 2:02:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
FileName_PostFix
SSNL
RECORD_ID
SR0081473
PE
2602
STREET_NUMBER
11065
Direction
N
STREET_NAME
ALPINE
STREET_TYPE
RD
City
STOCKTON
Zip
95212
APN
06304023
ENTERED_DATE
11/26/2019 12:00:00 AM
SITE_LOCATION
11065 N ALPINE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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General COC MAI Work Order"—II 1 00 <br /> O McCAMPBELL ANALYTICAL, INC. CUAIN OF CUSTODY RECORD <br /> O1 iia Willow Pass Rd. Pittsburg.Ca.94565-1701 Turn Around"I imc I Day Rush 2 Da,Rush 3 Day Rush I S'I'D 0 Quote# <br /> WO Telephone:(877)252-9262/Fax:(925)252-9269 ESI. Cleanup Appmscd Dty weight Bottle Order it <br /> www.mecampbelLcom main(a mccampbell.com Delivery Fonnec PDF Grofracker EDF FDD Write On ID\\') Detect Summary <br /> Report To:TAMARA WOODS Bill To: MACY HUMPHREY Analysis Requester) <br /> Company:TERRACON CONSULTANTS INC <br /> O <br /> Email:TAMARA.WOODS@TERRACON.COM CD <br /> Alt Email: Tele: 209-712-7159 LLI <br /> t M <br /> Project N,ame:WHITLOW PROPERTY Project H. NA197078 Z <br /> Pro- Q ject Location:11065 N.ALPINE ROAD,STOCKTON PO fA � <br /> Sampler Signature: j7Lti ( �j��,c��� H LU <br /> SAMPLE ID Sampling af U <br /> Matrix I'reseryamc <br /> Location %Field Point = m <br /> Daic Time _ Z <br /> GW-1 10-1-19 11 cc"rr% 1 GW • <br /> GW-2 10-1-19 2 GW ^aa• s,r, • <br /> TRIP BLANKS 2 <br /> VAI clients MUST disclose any dangerous chemicals knoren to be present in their suhmmcd snmplc�in concentrations that may cause immediate hams or serious(inure hcallh endaneemtent as a result of brief.gloved,open air.sample hardline by VAI staff. <br /> Non-disclosure incurs an immediate S250 surcharce and the client is suhlecl to fill legal liability for hams sufi <br /> fllercd.Thank you tt pour underslanding and for allowing us to work safcb. <br /> If metals are requested lirr water samples and the water type(Matrix)is not sfKcified on the chain of custody,MAI will default to metals by 1:20(1.x. Comments Instructions <br /> Please provide rot adequate volume of sample. If the columc is not sufficient lora NIS AISD a I CS/1-CSI)will be prepared in its place and noted in the repos. <br /> Relinquished By/Company Name I)ate I title Received By/Company Namc Date I line <br /> Matrix Code: DW=Drinking Water.GW=Ground Water.WW-Waste Water.SW-Seawater,S= if,SL SI td r .A-Air, WP=\\Iipe.O=Other � <br /> Preservative Code: l=4°C 2=HCI 3=H,SO, 4=1-IN03 5=NaOH 6=ZnOAcfNaOH S=Nvic Temps_"(' Initial. <br /> 1X <br /> Page of_ <br /> Page 9 of 10 <br />
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