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Chain of Custody Record Page of <br /> Project Name: ARCO 595 UST Removal On site Time: '.�p Temp: <br /> �- _ <br /> 4 QP BU/AR Region/Enfos Segment: BP>Americas>WestCoasf>Retail>WCBU> Offsite Time: t L Temp: <br /> CA>Central>595>HisloricalBL Sky Conditions: Clottov <br /> State or Lead Regulatory Agency: San Joaquin County Environmental Management Dept. Meteorological Events: I <br /> Requested Due Date(mm/dd/yy): — lob Wind Speed: Direction: <br /> qg o K <br /> Lab Name:Sequoia BP/AR Facility No.: 595Consultant/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/Lon : 38.02/-121.25 Sacramento,CA 95833 <br /> Lab PM.Lisa Race California Global ID No.: 70607700319 Consultant/Contractor Project No.: 38466562.0093001 <br /> Tele/Fax:408.782,8156/408.782.6308 Enfos Project No.: GOBZG-0002 Consultant/Contraetor PM: Vernon Elarth <br /> BP/AR PM Contact:Paul Supple Provision or RCOP: RCOP Tele/Fax: 916.717.5045/916.679.2900 <br /> dress:P.O.Box 6549 Phase/WBS: 08-Divestment Report Type&QC Level: Level 1 with EDF <br /> Moraga,CA 94570 Sub Phase/Task: 03-Analytical E-mail EDD To: Denise Yee u scorp.com <br /> Tele/Fax:925.299.8891/925.299.8872 Cost Element: 05-Subcontracted Costs Invoice to: Altantic Richfield Co. <br /> Lab Bottle Order No: Matrix Preservative Requested Analysis <br /> ti <br /> v <br /> r. <br /> Itemd o Sample Point Lat/Long and <br /> Sample Description Laboratory No. t~ o [� <br /> No. q o U pa „ Comments <br /> � o O pbO <br /> a MPA0 37- z x x x <br /> 10 <br /> 1 f Il- 2, 12-27A Y 01 Y I Y, Mail a copy of the analytical <br /> 2 �Pt 1612-5 � oz 2 report to: Michelle Le <br /> n� 3• <br /> 3 Y San Joaquin County <br /> 4 -- X535 `� o�! z Environments!Health <br /> Ln <br /> ilnn a rfm�nf <br /> 5 P Lj_tr0 fs.q or 2-. 304 E.Weber Avenue,Third <br /> W� I I GI, L5!95 0t' 2- Stockton,CA 95202-2708 <br /> 7 c)-7 z 209-468-3420 <br /> 8 <br /> 9 <br /> 10 <br /> Sampler's Name: Relinquished By/Affiliation Date Time Accepted By/Affiliation Dae 'Time <br /> Sampler's Company: <br /> Shipment Date: <br /> Shipment Method: <br /> Shipment Tracking No: <br /> rCuEstody <br /> nstructions: Ox entates=MEBF,TBA,DIPE,ETRE,TAME,1,2-DCA,ED13,and ethanol <br /> If total lead value is>50 m anal ze for lead by STLC. It' C value is>5 m analyze for lead by TCLP. <br /> Seals In Place Yes No Temp Blank Yes o Cooler Temperature on Receipt . V/C Trip Blank Ye. No <br /> n:,. .1 r+,. /D:..1.0...... uvr-nr v— i iaivae <br />