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tao C Laboratory Management Program LaMP Chain of Custody Record Z rye Page—i—of Z <br /> i c h 1 1 e I d BP/ARC Project Name ARCO Service Station No.-.i4#- 6DOC) Req Due Date(mm1dd1yy):-Qnw6y d TAT Rush TAT: es Ne---X— <br /> company <br /> �ABPaffiiia!e:ry BP!ARC Facility No: ( jam .�2a-4"3 Lab Work Order Number: <br /> Lab Name: Calsoence Environmental Lab BP/ARC Facility Address: 85 East Louise Ave,Lathrop,CA «' Consultant/Contractor Stantec Consulting Corp. <br /> Lab Address 7440 Lincoln Way,Garden Crave,CA 92841 City,State,ZIP Code: Lathrop,CA Consultant/Contractor Project No: DIRECT BILL STANTEC <br /> Lab PM: Richard Villafama Lead Regulatory Agency: San Joaquin County Environmental Health Dept Address: 3017 Kilgore Rd,Ste 100,Rancho Cordova,CA 95670 <br /> Lab Phone: 714.895.5494/Fax.714.894 7501 California Global ID No T0607700909 Consultant/Contractor PM. Brian Westhoff <br /> Lab Shipping Accnt: — Enfos Proposal No: DIRECT BILL STANTEC Phone: 916.861.0400 ext.270 <br /> Lab Bottle Order No: — Accounting Mode: Provision OOC-BU_OOC-RM_ Email EDD To: bpvalleyastanteC.COm <br /> Other Info: -- Stage: Activity Invoice To: BP/ARC X Contractor <br /> BP/ARC EBM: Sergio Morescalchi Matrix No.Containers/Preservative Requested Analyses Report Type&QC Level <br /> EBM Phone 925.275 3807 Standard X_ <br /> T <br /> EBM Emat; Seraio.rnorescalchiq�bD.COfn a Full Data Package— <br /> c U <br /> ON <br /> 0 <br /> m <br /> � O U � ❑ <br /> Lab Sample Description Date Time a a Lu Comments <br /> NO. o c D w XO Note:If sample not collected,indicate"No <br /> Z W. a Sample"in comments and single-strike out <br /> 00 o a 0 w and initial any preprinted sample description. <br /> v ¢ j 0 m <br /> 1 - A <br /> 2 Te, 13— z z <br /> Ja 1.1 <br /> 3 g - C - l2 f-'f13 [o53 <br /> 4 �,`( - � - (z 2 003 <br /> 5 8ti - 3 - IZ l2 ! <br /> 6 - G -( 14, 0 0 <br /> 7 `il - 4- (2, r2 13 <br /> 6 r7l — i3 - iz u <br /> 9 T1 1 -G - I 12 i 0 v <br /> 10 Q- 12— �J <br /> foo <br /> Samplers Name: Thomas Walsh Relinquished By/Affiliation Date Time ccep ed By I Affiliation Date Time <br /> Samplers Company Stantec Consulting �/ 2 j <br /> Shipment Method: GSO Ship Date: Z ' ell (D <br /> Shipment Tracking No. <br /> Special Instructions: OXYs:MTBE TBA DIPE ETBE TAME,ethanol Me�y�(tRo� <br /> THIS LINE-IAB USE ONLY: Custody Seals In Place.Yes/No Temp Blank:Yes/No Cooler Temp on Receipt °F/C Trip Blank:Yes/No MS/MSD Sample Submitted Yes/No <br /> BP/ARC LaMP COC Rev.6 01/01/2009 <br />