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ARCHIVED REPORTS_DRYWELL CLOSURE AND INVESTIGATION
Environmental Health - Public
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EHD Program Facility Records by Street Name
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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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McCampbell Anal tical, Inc. CHAIN OF CUSTODY RECORD <br /> O� y <br /> 1534 Willow Pass Rd./Pittsburg, Ca. 94565-1701 TURNAROUND TIME: RUSHL]; 24 HR[1,48 HR pin HR 0:5 DAY C5 4131 <br /> w C <br /> www:mccompbell.com/ main@mccarnpbell.com <br /> Telephone: (877) 252-9262/Fax: (925) 252-9269 Georracker EDpp: PDF[I EDDp Write on ID\��p eQurS p <br /> Effluent Sample Requiring`°J"llag El; UST Clean U Fund Project <br /> P J 0':claim'R 1 <br /> Rc ortTo: qe e; .,f Bill To: <br /> company: (V Anal sis Re nest <br /> I - 1 A AV <br /> S = E <br /> Alia r r .7z n <br /> Tele: ' •� - - _� -'e Fax: (- zi�-d <br /> Project N:G2V'� c i l _ S g <br /> Project Name: ip o w <br /> Pro•ect Location: �' `; <br /> Purchase Orflef•# <br /> Sam ler Sinnature: �. <br /> s` u" <br /> SAMPLING ,MATRIX METHOD - - =! = u ° ,�, 3 <br /> PRESERVED N -. c >• V c _ i' v O <br /> g _ <br /> SAMPLE ID Location/ z ¢ -_ <br /> Field Pain a �`+ <br /> Nam¢ Date Time <br /> CF <br /> F <br /> i.0 <br /> J L <br /> S a Q <br /> tJ <br /> - - - - - - - - - - - - - - - - - - - --- - <br /> 55 ll <br /> 4.I _ <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 ftrture health endangerment as a result of brief, <br /> gloved,open air,sample handling by MAI stag.Non-disclosure incursan immediate 5250 surcharge and the client is subject to fill]legal liability for harm suffered. Thank you for}'our understanding and for allowing <br /> us to work so a V. <br /> Retushed By: Date:/ Time: Received B ICER" , <br /> l� tJ,'-(�, GOODCONDITION COMMENTS: <br /> Relinquished <br /> DEAD SPACE ABSENT <br /> 9 Date/: Time: Re iv 1 By: DECHLORINATED IN LAB <br /> APPROPRIATE CONTAINERS_ <br /> PRESERVED IN LAB_ <br /> Relinquished By: Uatm Timr. Recur'ed By: <br /> VOAS O@G METALS OTIIER HAZARDOUS: <br /> PRESERVATION nIK2 <br /> Page 9 of 10 <br />
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