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a tic Laboratory Management Program LaMP Chain of Custody Record 0\�Ll Page Z or z <br /> chfieldZ" <br /> om pany BP/ARC Project Name ARCO Service Station Nom fp0� Req Due Date(mm/dd/yy):-ei�e�TAT Rush TAT: Ye <br /> QA BF affiliated company BP/ARC Facility No: _ _ �OD Lab Work Order Number. <br /> Lab Name: Calscience Environmental Lab BP/ARC Facility Address: 85 East Louise Ave,Lathrop,CA Consultant/Contractor. Stantec Consulting Corp <br /> Lab.Address 7440 Lincoln Way,Garden Grove,CA 92841 City,State,ZIP Code: Lathrop,CA Consultant/Contractor Project No DIRECT BILL STANTEC <br /> Lab PM: Richard Villafania 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 Cons ultanVContractor 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: bpvalley@Stantec.COm <br /> Other Info: -- StageActivity: Invoice To BP/ARC X Contractor <br /> BP/ARC EBM: Sergio Morescalchi Matrix No.Containers I Preservative Requested Analyses Report Type&QC Level <br /> EBM Phone: 925.275.3807 ° Standard X <br /> m <br /> T <br /> EBM Email: Sergi0.rncrP,SCBIchi(@bp.Com a < Full Data Package- <br /> C U <br /> C N_ <br /> O <br /> Lab Sample Description Date Time D c h Comments <br /> No. o E 2 w > <br /> u) Z m �„ 0 Note:If sample not collected,indicate"No <br /> > a Sample"in comments and single-strike out <br /> .oo a w and Initial any preprinted sample description. <br /> (n Q F 1 0 m <br /> It V- ) Z � X <br /> 12 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Sampler's Name: Thomas Walsh Relinquished By/Affiliation Date Time Acc pted By/Affiliation Date Time <br /> Sampler's Company:, Stantec Consulting (3 o r l <br /> Shipment Method: GSO Ship Date: CD <br /> Shipment Tracking No. <br /> Special Instructions: OXYs:MTBE,TBA,DIPE,ETBE,TAME,ethanol;w«4-.u4,1 b 1 bDls <br /> THIS LINE-LAB USE ONLY: Custody Seals In Place:Yes/No I Temp Blank:Yes/No I Cooler Temp on Receipt °F/C Trip Blank:Yes/No MS/MSD Sample Submitted:Yes I No <br /> BPIARC LaMP COC Rev.6 01/01/2009 <br />