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CO0047038
Environmental Health - Public
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2200 - Hazardous Waste Program
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CO0047038
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Entry Properties
Last modified
8/22/2022 4:16:59 PM
Creation date
2/8/2019 8:03:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
RECORD_ID
CO0047038
PE
2200
STREET_NUMBER
18201
Direction
S
STREET_NAME
MACARTHUR
STREET_TYPE
DR
City
TRACY
Zip
95304
APN
21302050
ENTERED_DATE
7/3/2018 12:00:00 AM
SITE_LOCATION
18201 S MACARTHER DR
RECEIVED_DATE
7/2/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
FilePath
\MIGRATIONS\M\MACARTHUR\18201\CO0047038.PDF
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EHD - Public
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e <br /> - o <br /> CHAIN OF CUSTODY I ANALYSIS REQUEST �j N <br /> Attention Mark Dysert Phone (650)799-9204 Billing (if different) LO <br /> Company Name Dysert Environmental Email environmental.data@gmail.com Attn:Accounts Payable <br /> Mailing Address P Q Box 5608 Fax (650)627-4968 Dysert Environmental,Inc. <br /> City, State & Zip San Mateo, CA 94402 P.O. No. l y q{} - I P.O Box 5608 <br /> Lal? I.D. -TA S - Samplerls San Mateo, CA 94402 <br /> Project Z eq Q GU it C i In Project 956 Hobart Street 11111111111111111111111111111 <br /> Name411111111111,720 Location Menlo Park, CA 724-86460 Chain of Custody- 2*460 <br /> - 1 <br /> Sample Matrix = arnoleContaine Used: <br /> Solid r GL o m m d a a <br /> cu rl © ._ � � � a '-X LU 0 ,0 <br /> Turn Around ,.PT 3 =' a— 0� � c Q a o ° �� o � � � a y V <br /> Time �LL2„ � � a � n 017141 <br /> , S ° c Lj c Q ap^ o a 'iy 1n ga '� qr <br /> am ,om >co a.In o Q 0 � ) m m QY- ie x mrn w <br /> C7 Vi r 4M rp V ill W m 1< Q U <br /> LO <br /> No. of am = o W �' �, �; a � 0J X <br /> Sample tD: Date,. Time: Containers ~ � ' ` Q o <br /> 602 GL JAR X X X A X <br /> f � <br /> �I <br /> S1-Z' ti 1X 16OZ GL JAR X a <br /> S11-31 -. 3 i 1 X 16OZ GL JAR X <br /> 1 X lwz GL SAR X <br /> S2-2' t 1 X 160ZGL JAR X <br /> JJJJJ S2-3i 'L�,,.'� 1602 GL JAR X X X X X <br /> Tl S3-1' f Cf1 i 5 1 X 1fiGZ GL JAR r X <br /> Relengwshed by ` / Received by r � 7imu try/ Dale{� Lab Notes: <br /> Relinquished by a� �l Received by Time J 7 Od9eJ Please"J" Flag results <RL and>MDL. <br /> elke C0tAt;4-1" _ Please report TPH D/MO/G in mglkg. Need <br /> Rehngw.hed byReceived b .R 2C Y limn Gare lowest possible RL,IMDL for Pesticides and <br /> dangw hedby - Recmvedby ^ CIi Time oa SVOCs. Endrin and Endrin Aldehyde need <br /> Qt � J[ () j -- 11� 4.65 ug/Kg MDL. Please do not dilute. <br /> Note (��'L. �r L.h r t►� ' Sates: <br /> Were samples deliev�rmed7 field sampling? A y 1G jA-1 lout ONSITE CONTACT: <br /> Were samples recieved in a cooler with ice? y'5 <br /> What type of ice was used? t�Zt o Sample Location Map AttachedYES r NO(circle one) <br /> Sale Temperature and Time upon Recepit in Lab= <br /> Dysed l7notonmentai. Inc (ELAP#2764) , Page of y <br /> Tel (650) 799-9204 Web DysertEnvrronmental com <br />
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