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Chain of Custody Record <br /> �_ <br /> Project Name: ARCO 595 UST Removal On-site Time: 30 '1•cmP: <br /> BP BU/AR Re ion[Enfos Segment: , Offsite Time: <br /> �' g BP Americas>West Coast>Itulnll>WCNI1 ��t 0 c7 <br /> CA>Central>Y)!)>I tistolicAilt Sky Conditions: e'f,g,4 D 4 <br /> State or Lead Regulatory Agency- .`:nn,lo;uluin coualy I nvinounonlnl Mntuglolrool Doul Mcleoroloyical Rvents <br /> Requested Due Date p� �Nind b���r+l� I ii+cction: <br /> BP/AR FacilityNo.: 595 Consultant/Contractor. 111LS <br /> FrAdddresg-: <br /> :Se uoia Address: 2870 Gateway Oaks Drive,Suite 300 <br /> 85 Jarvis Drive <br /> Address: 6 L00 N 1 <br /> Mor an Hill,CA 95037 Site Lat/Lon 38.02/-121.25 Sacramento,CA 95833 <br /> California Cllobnl I I)No.: '1.0607700319 - -- Cons11111111I/1'onlrarl+a Project No. 38466562.0093001 <br /> Lisa Race linfosProject No.: (i01i%(iOlH17 1'nas�llanl/('on'MclorJIM: VernonElarth <br /> Tele/Fax:408.782.8156/408.782.630 — <br /> Provision or ItCOP: V(14, _ t'r.lc/1°ox: 916.717.5045/910.679.2900 <br /> '/AR PM Contact:Paul Su le <br /> l'lusc/VJ13S: 08-Divestment Ree — <br /> ort T e& C Level: Level 1 with EDP <br /> ddress:P.O.Box 6549 Sub phase/Task: 03-Anal ical f?-mail EDD To: Denise Yee@urscorp.com <br /> Mora a,CA 94570 Cost Element: 05-Subcontracted Costs Invoice to: Altantic Richfield Co. <br /> Tele/Fax:925 11, /925.299.8872 Matrix Preservative Requested Analysis <br /> Lab Bottle Order No: H <br /> Sample Point 1,at/Long and <br /> •d Laboratory No. c) ,� <br /> Item Sample Description .1 `�1 0 Comments <br /> No. O� .� <br /> MPA O W-33 z x x ° <br /> Mail a copy of the analytical <br /> report to: Michelle J <br /> l p-v <br /> 2 -aa rPt 1 D — San.1oaquin County <br /> - Envlronmenlal health <br /> 4 <br /> 304 E. Weber Avenue,Third <br /> 5 Stockton, CA 95202,2708 <br /> 6 209-468-3420 <br /> 7 <br /> 8 <br /> 9 <br /> 10 �� Relinquished By/Affiliation Datc Time Acee)ted I /Affiliattau ate1'lme <br /> Sampler's Name: 0 6 :35 <br /> Sain ler's Conn an : - <br /> Siu nlent Date: <br /> Shi meat Method: <br /> Shipment Tracking No: 1,2-DCA,EDB and ethanol <br /> + ETBE TAME,1, � <br /> S)ecial Instructions: Ox entates=MtBE,TBA,DIPB, , <br /> If total lead value is>50 m anal ze for lead b STLC.-f, C value is>S pm analyze for lead by T I;P. <br /> CeZe Blank Cooler Temperature on Receipt SOF/C Trip Blank Yes No <br /> NO nw d la/1/nd <br /> ' � stody Seals In Place Yes - - `^ <br />