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Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0538738
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Last modified
2/6/2020 10:20:26 AM
Creation date
2/6/2020 9:20:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0538738
PE
2950
FACILITY_ID
FA0022243
FACILITY_NAME
NEIL O ANDERSON & ASSOC INC
STREET_NUMBER
902
STREET_NAME
INDUSTRIAL
STREET_TYPE
WAY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
902 INDUSTRIAL WAY
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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I c}a X40 4 7— <br /> McCampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br /> TURN AROUND TIME:Rvsx❑ 24 HR 4s HR _ 72 HR 1534 Willow Pass Rd./ Pittsburg, Ca.94565-1701 ❑J ❑1 ❑15 DAY ,j10 DAY ❑ <br /> www.mccampbell.com/ main@mccampbell.com GeoTracker EDF[a PDFQ EDDQ writeon(DV✓)❑J EQutS❑j <br /> Telephone: (877) 252-9262/Fax: (925) 252-9269 <br /> Effluent Sample Requiring"X'Hag E3J UST Clean Up Fund Project Q;Claim# <br /> Re ort To: RPS Bill To: fyefl 0, Analysis Request _ i <br /> Company: - u, v <br /> E?-M33atUil: t6a5 <br /> h P(=tiPpp i' 'k— E <br /> Fax: 1d -Tele: _ <br /> Project#: v ProjectName: OR P % u <br /> Pro Location: A- Purchase Order# <br /> •Y�uO1Z <br /> Sampler Signa <br /> ture: o o :5 <br /> SAMPLING MATRIX McHNPRzO <br /> SAMPLEID Location/ <br /> 4 <br /> Field Petal 's — <br /> DtTime <br /> Name U U Zo o o 2 W iW W W I. <br /> ,Mt <br /> • <br /> W <br /> Ps-/'—.r ud9/I + I )< I X <br /> zesl�- it I X IXI Ix I— X <br /> rye e5 s'— r IX X XX <br /> 61e — II: sl, 1 X <br /> W9-- Il"U 0l <br /> a— 3ly <br /> � wa- Imo' • S 1 <br /> z`2a X <br /> X\ wa-ut L Z3 X <br /> --MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate harm or serious future health endangerment as a result of brief, <br /> gloved,open air,sample handling by MAI staff.Non-disclosure incurs an immediate 52250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing <br /> us to worksafel . <br /> Rel'nquished By: Date: Time: Received By: ICE/t` COMMENTS: cmta rem tfr <br /> -ILL - ; GOOD C ND TION <br /> 2� V HEAD SPACE ABSENT 46 -ao 30-( v"A (0- - <br /> Relin uish y: Date. 'Time: c' By: DECHLORINATED IN LAB I <br /> / APPROPRIATE CONTAINERS F,14 <br /> 1) , y[NS/7G✓U' <br /> ' <br /> PRESERVED IN LAB_ CON Npll d• AACU(S'714-4-4r. <br /> Relinquished By: Date: Time: Received By: VOAS O&G METALS OTHER HAZARDOUS: <br /> PRESERVATION nH12 a <br /> Page 76 of 78 <br />
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