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t�o� <br /> Afla C Laboratory Management Program La/M�P Chain of Custody Record G Page r of <br /> i C 1 1 e I d BP/ARC Project Name ARCO Service Station No� &0&0 Req Due Date(mm/ddlyy): TAT Rush TAT: Y Npr� <br /> ompany — <br /> BP/ARC Facility No: lgDE'� <br /> Lab Work Order Number: <br /> Q A BP afi�lia!ed company - ------ <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 BIL_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.: 70607700909 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 bpyalleyC@Stantec.COrn <br /> Other Info: Stage; Activity: Invoice To: BPfARC X Contractor <br /> BP/ARC EBM: Sergio Morescalcht Matrix No. Containers I Preservative Requested Analyses Report Type&QC Level <br /> EBM Phone: 925 275.3807 N Standard- X <br /> EBM Email: Serglo.moreSCalchl(rybp.Com e S Full Data Package <br /> c v <br /> m o <br /> a 0 N <br /> NoSample Description Date Time Q d Lu Comments <br /> 0z m >, Note:If sample not collected,indicate"No <br /> > m ;zo Sample"in commens and single-strike out <br /> -o = o a 0 ` and initial any preprinted sample description <br /> n ? G t7 m <br /> -� A LQ <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Samplers Name. Thomas Walsh Relinquished By/Affiliation Date Time cepted By/Affiliation Date Time <br /> Sampler's Company: Stantec Consulting 2 O <br /> Shipmert Method GSO Ship Date. (D <br /> Shipment Tracking No: <br /> Special Instructions: OXYs:MTBE,TBA.DIPE ETBE TAME,ethanol* w1 Qf N <br /> THIS LINE-LAB USE ONLY: Custody Seals In Place:Yes/No I Temp Blank Yes/No Cooler Temp on Receipt: °F/C Trip Blank:Yes/No I MS/MSD Sample Submitted.Yes/No <br /> BP/ARC LaMP COC Rev.6 01101/2009 <br />