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y Chaim of Custody Record llgo _ t <br /> -n-: •-�G'�• bp Project Name; ARCO 895 UST Renwval On-site '1'iinc: Ct;� <br /> 13P13U/ARRegion/EnfosSegment: 8P>Ameis s>WestCoast>Retall>WcBU> Off-site 'Time: �.2:00 Ccmp: <br /> CA>Central>595>HistorMOL Sky Conditions: C loci Q r/ <br /> State or Lead Regulatory Agency: San Joaquin County Environmental Management Dept. [Meteorological Events: <br /> Requested Due Date(mm/dd/yy): J AN V? 200a [Wind Speed birection: <br /> [Lab Name;Sequoia _ [BP/AR Facility No.: 595 [Consultant/Contractor. URS <br /> [Address:885 Jarvis Drive [Address: 6100 N I [Address: 2870 Gateway Oaks Drive,Shite 300 <br /> [ Morgan Bill,CA 95037 [Site LaIlLong_ 38.02/-121.25 [ Sacrametlto,CA 95833 <br /> Lab PM:Lisa Race [California Global ID No.: T0607700319 �onsultant/C <br /> onsultant/Contmctor Project No.: 38466562.0093001 <br /> TelctFox:408.782.8156/408.782.6308 113nfos Project No.: GOBZG-0002 ontractor PM- Vernon Elarth <br /> IBP/AR PM Contact Paul Supple Provision or RCOP: RCGP ele/Fax: 916.717.5045/916.679.2900 <br /> -- -- <br /> Address:P.O.Box 6549 Phase/WBS: 08-Divestment Report Type&QC Level: Level l with EDF <br /> Moraga,CA 94570 Sub Phase/Task: 03.:Analytical E-mail P,DD To: Denise_Yee@urseorp.com - <br /> Tele/Fax:925.299.8891/925.299.8872 4Cost Blement: 05-S ubcontracted Costs Invoice to: Altatttic Richrield Co. <br /> Lab Bottle Order No: _� Matrix I Preservative r --Requested Analysis <br /> -- <br /> _.. _ 1�PA�/7� <br /> On <br /> d <br /> y atnpieP at/Long and <br /> ilt�em Sample Description A o Laboratory No. o Comments <br /> o <br /> -, -- Cn <br /> � � -� --•=-:.: .7 � :�$1 �: x _� - t�7 ..�_�.-_ ---•— •-- Mail a copy of the anal tical <br /> 1 _IDS-I� � .... IIo•;0U-3•a�l . L._ I IyI I I_.._I _ IX-fx x _ _... --- ly y <br /> 2 I ;) .�q- 1,3�.. I{�v25 h'3b� report to: Michelle Le <br /> 3 L _I. San Joaquin County <br /> - — -- -- -- — &nvironinental Health <br /> 4-I- -- - I—_ I _. .. ... .I I I.. - --- - --._ nennrtinent <br /> $ _ I _ I __-___ I I I I —-- •. I I 304 E.Weber Avenue,Third <br /> 6 - _ I I I —__ I. . _. I - .- .. _I (Stockton,CA 95202-2708 <br /> -7 _... ... .. .... I - L. I I. I I —I. . [209-468-3420_ <br /> I 8 . - ---... . I _ _I .. . _ I I _I- I .. I - -_—L_i--•-•- I ._. . I i I_. I <br /> I <br /> 10 I I I i I 11 .. . I --• I ... I.__..L I I_ _.. ... I L I I ... — - <br /> [Saiiipler'sName: �;il _ (4-AAl-'r� ReliAigidyltcdliy/Afttilatton DateTry � 'Brat [I - kceptc+lBylACniIxi[an (�te 'rlme <br /> mpler's Company: 0 -S �� <br /> Sa <br /> — <br /> ,Shipment,Date: <br /> Shipment Method --- <br /> +Shipment Tracking No: <br /> Special Instructions: Oxygentates MtBE,TBA,DTPE,LTBE,TAME,14-DCA,EDB,and ethanol <br /> ' If total lead value is�su_ppm anCvalueis>Spprnfina"IorJeadbv TCLP. <br /> - - <br /> Custody Seals In Place Yes No T Temp Blank Yes. _No__ Cooler Temperature on Receipt �/C Trip Blank Yes No <br /> —. -_ <br /> i lie�riL,,,finn• WhiiP C!rnw-I ahnratnry/Yellow Conv-RP/Atlantic Richfield Co. /Pink Coov-ConsultardContractor BP cot:ztev a toA/o4 <br />