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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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RLJO LL agEd <br /> O` t McCampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br /> WG TURNAROUND TIME:RUSH Ell 241-IR❑48 HR 072 HR <br /> 1534 Willow Pass Rd./ Pittsburg, Ca. 94565-1701 � ❑s DAY �to� ❑. <br /> www.mccampbell.com / main@mccompbell.com <br /> Telephone: (877) 252-9262/Fax: (925) 252-9269 GeoTrackerEDFQ PDF❑; EDDQ Write0n(D\V)❑1 EQuIS❑ <br /> Effluent Sample Requiring"J"flag ' UST Clean Up Fund Project❑,;Claim# <br /> Re ort To: Bill To: <br /> Anal sis Request <br /> Company: <br /> Cts — n <br /> E-Mail: <br /> Tele: Fax: a <br /> Project 4: Project Name: <br /> Project Location: Purchase Order# _ - e-, e — `-e <br /> Sam ler Si nature: y _ _ u <br /> SAMPLING MATRIX METHOD ci a ,`W_, ? r <br /> PRESERVED '+ . >, 0 <br /> Location/ <br /> me 3Lv > ALu ? a <br /> ' OSAMPLE IDField Poin u $ <br /> Name zi <br /> n 00 i E <br /> U O C 3 S •_ 7 rl O G1 Ti G p G] vl V N h VI Po a <br /> a G ! G u, yr ¢ v O S O m F- F F F m m m ev U a E is <br /> 1: _ �.wP3a1X <br /> "MAI clients MUST disclose may dangerous chemicals(mown 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,openair,sample handling by MAI staff.Non-disclosure incosan immediate$250surcharge and the client issubject to full legal liability for harm sufferred. Thankyoo foryour understanding and for allowing <br /> as to work safely. <br /> Relinquished By: Date: Time: Received BY; -. !. ICE/t` COMMENTS: <br /> GOOD CONDITION_ <br /> —"'• HEAD SPACE ABSENT <br /> Relinquished By: Date: Time: R ceiv Bv: DECHLORINATED IN LAB <br /> / APPROPRIATE CONTAINERS_ <br /> PRESERVED IN LAB_ <br /> Relinquished By: Date: Time: R ived By: VOAS O&G METALS OTHER HAZARDOUS:✓ <br /> PRESERVATION nI1<2 <br />
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