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i <br /> Chain of Custody Record Page of <br /> a: Project Name: ARCO 595 UST Removal On-site Time: t C) Tem <br /> bp <br /> BP BU/AR Re on/Erlfos Segment: <br /> BP>Ameticas>West Coast>Retail>WCBU> Off-site Time: ,j Temp: <br /> CA>Cenital>595>ltisloricalK Sky Conditions: <br /> State or Lead Regulatory Agency: San Joaquin County Environmental Management Dept. Meteorological Events: <br /> Requested Due Date(mm/dd/yy): —a Wind Speed: Direction: <br /> ! © <br /> OA <br /> Y <br /> Lab Name:Sequoia BP/AR FacilityNo.: 595 Consultant/Contractor, URS <br /> Address:885 Jarvis Drive Address: 6100 N I Address: 2870 Gateway Oaks Drive,Suite 300 <br /> Morgan Hill,CA 95037 Site Lat/Long: 38.021-121.25 Sacramento,CA 95833 <br /> Lab PM:Lisa Race California Global ID No.: T0607700319 Consultant/Contractor ProjectNo.: 38466562.0093001 <br /> Tele/Fax:408.782.9156/408.782,6308 Enfos Project No.: GOBZG-0002 Consultant/Contractor PM: Vernon Elarth <br /> BP/AR PM Contact:Paul Supple Provision or RCGP: RCOP Tele/Fax: 916.717.5045/916.679.2900 <br /> Address:P.O.Box 6549 PhasefWBS: 08-Divestment Report Type&QC Level: Level 1 with EDF <br /> Morago,CA 94570 Sub Phase/Task: 03-Analytical E-mail EDD To: Denise Yee ursco .com <br /> Tele/Fax:925.299.8891/925.299.8872 Cost Element: 05-Subcontracted Costs Invoice to: Altantie Rich&el Clo-- <br /> Lab Bottle Order No: Matrix PreservativeRequested Analysis <br /> p�4 U13 � <br /> No. Sample Description A o Laboratory No. o b ample oint Lat/Long and <br /> Enw ti j Comments <br /> ti <br /> CIOZ x x o <br /> l �QQ— Mail a copy of the analytical <br /> v <br /> 2 `z 6 Z report to:Michelle Le <br /> 3 San Joaquin County <br /> 4 Pj"' (j!p „5, l Environmental Health <br /> 5t)nnnrtrnent <br /> `�—57 (� �� 304 E.Weber Avenue,Third <br /> 1 Stockton,CA 95202-2708 <br /> 7 ` �� �3,2� b fi 209-468-3420 <br /> Sampler's Name: #ZJ If• J- Rcllnq,dshedBy/Afllltation Date ISme Accepted y/Afflliatton Dae 11me <br /> Sampler's Company: Ut2 e !Z Z9v ft-2F),' D (7 <br /> Shipmeat Date: `1' -O� <br /> Shipment Method: <br /> Shipment Tracking No: <br /> S ecialIInstructions: Oxygentates=MtBE,TBA,DIPE,ETBE,TAME,1,2-DCA,EDB,and ethanol <br /> If total lead value is>50 ppm analyze for lead by STLC. IC value is>5 pm analyze for lead b TCLP. <br /> Custody Seals In Place Yes_No Temp Blank o Cooler Temperature on Receipt 5, T/C Trip Blank Yes No <br /> Distribution: White C onv-T aboratnry/Yellow C nnv-RP/Atlantic R,r <br />