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SU0011127 SSNL
Environmental Health - Public
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SU0011127 SSNL
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Last modified
5/7/2020 11:34:58 AM
Creation date
9/4/2019 10:34:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0011127
PE
2631
FACILITY_NAME
PA-1600261
STREET_NUMBER
12023
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237-
APN
05132008
ENTERED_DATE
11/21/2016 12:00:00 AM
SITE_LOCATION
12023 E BRANDT RD
RECEIVED_DATE
11/18/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\B\BRANDT\12023\PA-1600261\SU0011127\SS STDY.PDF
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EHD - Public
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General COC MAI Work Order# iI nE 14 <br /> ® McCAMPBELL ANALYTICAL, INC. <br /> CHAIN OF CUSTODY RECORD <br /> O1534 Willow Pass Rd.Pittsburg.Ca.94565-1701 Tum anund Time:I Day Rush 2 Day Rush 3 Day Rush STD • Quote# <br /> WO Telephone:(877)252-9262/Fax:(925)252-9269 1-Flag/MOL ESL I Cleanup Approved Bottle Order# <br /> www.mecampbell.com main0meeemi)bell.eom Deliver Format: PDF • GeoTracker EDF EDD Write On(DW) EQu1S <br /> Report To:TAMMY WOODS Bill To:DORA DELISE Analysis Requested <br /> Company:TERRACON CONSULTANTS,INC. <br /> Email:TKWOODS@TERRACON.COM <br /> Alt Email: Tele:209-367-3701 < <br /> d <br /> Project Name:RECREATIONAL SERVICE FACILITY project#:NA177006 W <br /> Project Location:12023 E.BRANDT ROAD.LOCKEFORD,CAPO# Z m <br /> Sampler Signature: N W <br /> W <br /> SAMPLE ID Sampling u to U <br /> Matrix Ptnserative :t—, In 0 <br /> Location/Field Point <br /> Date Time a Z C) 2 <br /> GW1 - 12008 E. Brandt Road 03-30.2017 -Z'Sq1 WATER • <br /> GW2(1 of 2) -12008 E.Brandt Road 03-30.2017 •d0 1 WATER • <br /> GW2(2 of 2)-12008 E.Brandt Road 03-30-2017 r,1 WATER • <br /> MAI clients MUST disclose any dangerous chemicals known to[it present in their submitted samples in concentrations that may cause immediate harm or serious future health endangerment as a resin of brief.gin ed,open air,sample handling by MAI staff. <br /> Nor,h,cloaue incurs an immediate 5250 surcharge and the client is subject to full legal liability for harm suffered.Thant:lou for your understanding and for allowing us to work safely. <br /> If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody-MAI will default to metals by E200 s Comments/Instructions <br /> Please provide an adequate volume of sample.If the volume is not sufficient for a MS/MSD o LCS/LCSD will be prepared in its place and noted in the report. <br /> Relinquighed By/Company Name ?j D -rime Received By/Company Nam,, Date Time <br /> 7 UM3u 6u <br /> 1`+y <br /> Matrix Code:DW=Drinking Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S=Soil.SL=Sludge,A=Air,WP=Wipe,O=Other <br /> Preservative Code: 1=4eC 2=HCI 3=H,SO, 4=HNO, 5=NaOH 6=ZnOAc/NaOH 7=None Temp=-C Initials <br /> Page_of <br /> Page 10 of 11 <br />
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