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ARCHIVED REPORTS_DRYWELL CLOSURE AND INVESTIGATION
Environmental Health - Public
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PR0538738
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ARCHIVED REPORTS_DRYWELL CLOSURE AND INVESTIGATION
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Entry Properties
Last modified
2/6/2020 10:55:54 AM
Creation date
2/6/2020 9:25:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
DRYWELL CLOSURE AND INVESTIGATION
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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EHD - Public
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M6L.10 "L lOd a= M a* M W M M W M Mt M W M <br /> O� Mccampbell Analytical, Inc. <br /> CHAIN OF CUSTODY RECORD <br /> rr <br /> G 1534 Willow Pass Rd. / Pittsburg,Ca. 94565-1701 TURNAROUND TIME:RUSrIE3 24HR❑,as HR❑Irz HR ❑;5 oar Q1 ❑ <br /> www.mccampbell.com / main@mccampbell.com GeoTracket EDF❑ ❑ <br /> PDF ' HDD❑1 Wtite On(DP�❑, eQn[s❑ <br /> Telephone: (877) 252-9262/ Fax: (925) 252-9269 <br /> Effluent Sample Requiring".1"Hag❑I UST Clean Up Fund ProjectE];Claim 9- <br /> Report <br /> Re ort To: Bill To: Anal sis Re nest <br /> Company: <br /> Ctc _ F <br /> n <br /> E-Mail m y <br /> Tele c <br /> Fax: $ <br /> Project#: Project Name: <br /> Project Location: Purchase Order# <br /> Sam ler Si nature: �: _ a t <br /> SAMPLING MATRIX I THOn v a C > a r c <br /> PRESERVED m o. :-`E e F ^1 C5 <br /> Nj ..1 r tl L b pe• 09 <br /> Location/ <br /> w O x Z U Z <br /> SAMPLE ID +. E Y _ X <br /> Field Poirn <br /> Name Date Time 3 °° r- c = tl „ W „ " <br /> o "� c: a` .� a ^o" <br /> o i- <br /> -tv <br /> �: /.W �a 3� 1 x <br /> 4--# ---- - --- ---- -- <br /> ---- ------- ---- -- <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 endmtgerment as a result of brief, <br /> gloved,open air,sample handling by MAI staff.Non-disclosure incurs an immediate 5250 surcharge and the client is subject to fill legal liability for harm suffered. Thank you for your understanding and for allowing <br /> us to work safely. <br /> Relinquished By: Date: Time: Received By: .— ICE/t' COMMENTS: <br /> GOOD CONDTTION <br /> HEAD SPACE ABSENT <br /> Relinquished By: D e: Time: R ceiv Bv: DECHLORINATED IN LAB <br /> /� APPROPRIATE CONTAINERS_ <br /> PRESERVED IN LAB_ J (� <br /> Relinquished By: Date: Time: 111rdived By: VOAS O&G METALS OTHER HAZARDOUS: <br /> PRESERVATION 1311121 <br /> { <br />
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