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COPAGGF7Q (2)
EnvironmentalHealth
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I-5 AT DOWNING
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2500 – Emergency Response Program
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COPAGGF7Q (2)
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Entry Properties
Last modified
2/8/2022 3:11:15 PM
Creation date
2/8/2022 3:07:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COPAGGF7Q
PE
2546
STREET_NUMBER
0
Direction
S
STREET_NAME
I-5 AT DOWNING
STREET_TYPE
AVE
Zip
95206
APN
NEAR 17508012
ENTERED_DATE
6/30/2020 12:00:00 AM
SITE_LOCATION
SOUTH BOUND I-5 AT DOWNING
RECEIVED_DATE
6/30/2020 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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CASTLE ANALYTICAL LABORATORY cL,sq-tf2 c.20D---1 0 IL+ CHAIN OF CUSTODY <br />Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 <br />Phone: 209 384-2930 - Fax: 209 384-1507 <br />Certificate No. 2480 <br />PAGE <br /> <br />OF <br /> <br />Customer: ,/i-,-.7 ///7".- SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX rsoil(s) liquid(I) vapor(v) other (o) REQUESTED ANALYSES NUMBER OF CONTAINERS I Method of Shipment: <br />/Address: BTEX/MTBE/TPH-GAS 8021/8015 TPH-DIESEL -8015 TRPH 418.1M / SM5520C & F Oxy's / EDB / DCA by 8260 8260 - full list PCBs - 82 . ......_ <br />4i <br />k----- <br />icl <br />' Electronic Deliverables (EDF) City/State/ZIP; Notes: <br />Phone / FAX: <br />Proj# / PO# /Global ID: <br />Report Attention: <br /> <br />_ <br />Sampler Signature: ' <br />Printed:7e--7'.-/ /-7-7-(--- ,Sampler <br />Lab ID# SAMPLE ID DATE TIME DESCRIPTIO /LOCATION OBSERVATIONS/REMARKS <br />Clkl afa55g <br />, <br />Signature Printed Name D te, Time Company Name <br />Total number of containers <br />submitted to the laboratory <br />Relinquished by: .6/1b/PW"/ — 2j'4-2,0 /5-— Turn <br />24 <br />48 <br />3 <br />5 <br />Around Time: <br />1.—c..---e Ar" TELZ, cdr-LA-3 C/LA-t —,/ <br />:At" /I .----5-,_s7-1,,-e Hour Received by: ) <br />Relinquished by:\ Hour 1 1 <br />Received by: Day 1 1 <br />Relinquished by: Day (Normal) <br />Special: Received by:
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