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la Vice Laboratory Management Program LaMP Chain of Custody Record Z,,I 1102Page Z ofCl d BP/ARC Project Name ARCO Service Station No.Zi4� (p0� Req Due Date(mm/dd/yy)—6la�I�ICTAT Rush TAT: Ye <br /> ompany �1 — <br /> (�n6p affiliated company BP/ARC Facility No: 600) 4SX;=' 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 Cons ultant/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 714 694.7501 California Global ID No.: T06077DO909 ConsultanVContractor 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. 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 N Standard X <br /> EBM Email: Sergio.morescalchi(ftl).com d ¢ Full Data Package— <br /> C U <br /> N <br /> 0 n <br /> o c p <br /> Lab Sample Description Date Time = a � Comments <br /> No. ? E Z r <br /> -5 Z w U XO Note:If sample not collected,indicate"No <br /> y > y 0Sample"in comments and single-strike out <br /> m a 0 w and initial any preprinted sample dscr <br /> eiption. <br /> 0 ca <br /> 11 p_ _ Z 2 111v <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 /> Samplers Company: Stantec Consulting <br /> Shipment Method: GSO Ship Date: i { / (D <br /> PC <br /> Shipment Tracking No: <br /> Special Instructions: OXYs:MTBE.TBA,DIPE,ETRE,TAME,ethanol,MJ41%0411 61 $DIS <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 I MS/MSD Sample Submitted.Yes/No <br /> BP/ARC LaMP COC Rev.6 01/0112009 <br />