Laserfiche WebLink
CHAIN OF CUSTODY RECORD <br /> Lab Name, EQUIVA Services LLC - <br /> Lab Addrf Company Contact(s)for Invoice: INCIDENT NUMBER DA'rE: <br /> PAGE: <br /> FAX: <br /> Technical Services 9 8 9 9 5 8 7 4 --l_OF—I <br /> — <br /> TEL:( <br /> EQUIVA PROJECT CONSULTANT(Name and Company): SITE ADDRESS: <br /> Owen Ratch e-Cambria Environmental Technology, Inc. 341 East Main Street, Ripon, Ca. <br /> ADDRESS: <br /> 6262 Hollis Street EQUIVA CONTACT: COI,SULTANT PROJECT N0.:24 <br /> I <br /> CITY: Karen Petryna <br /> Emeryville, Ca SAMPLER(S)' IGNATURE) LAf .USE ONLY �I <br /> TEL FAX: E-MAIL I�%%J± CJ ❑-001=...I <br /> (510)450-1984 (510)450-8295 oratchye@cambria.env <br /> TURNAROUND TIME(BUSINESS DAYS) REQUESTED ANALYSIS <br /> 10 DAYS ❑ 5 DAYS E] 72 HR ® 48 HR 24 HR 0 X24 HR <br /> © LA-RWQCB REPORT FORMAT UST AGENCY: San Joaquin Co. c <br /> MTBE CONFIRMATION: HIGHEST HIGHEST per BORING ALLw N r a <br /> Co m - " m 0 w <br /> SPECIAL INSTRUCTIONS OR NOTES: TEMPERATURE ON RECEIPT(C) � <br /> � tv <br /> c 1171w O n c "0 <br /> (13 <br /> Ln o m a N a Q a ¢ <br /> Oxygenates to include Ethanol,TBA, EtBE, MtBE,TAME, DIPS m `� m x o o �, o X <br /> w _ <br /> T3 °� + �, I71 F G7 [� S!I <br /> m 1° w w H "� 8 Y + a C3 u ° M <br /> Detection Limits: TPH =50 b, BTEX=0.5ppb, MtBE=0.5ppb, DIPE=1.Oppb, �, ro to o i; m `o ti z o <br /> 9 pp c N — z o o a _ L- <br /> EtBE=1.0 b TBAw b Ethanol=100 b w u- L) o .. _ �^ d > <br /> I.RB SAMPLING ' X X N w m m r r ° v 0 `o o `m <br /> MAT- NO.OF w w U 0 IL a a a rl H t <br /> USE Field Sample Identification RIX CONT. a. 0. I- o d �, M w W w <br /> ONLY DATE TIME h [a m 7 W F Ul > > 7 H O <br /> H2O 4 x x x <br /> H2O 4 x x x <br /> Al � <br /> 1131 .� H2O 4 x x x <br /> I <br /> E 1 i H2O 4 x x x <br /> �00LEI t CISTI)DA SE LSJ IN AC <br /> 10T IN AC <br /> 0 <br /> n e :(Signature) Recenm�a re) Date: Time: <br /> Relinquish (Signature) Received by:( ' 1 Date:/ —) Time: <br /> by <br /> I-Fe-finquistlEdby:(Signature) V Received by:(Signature) y <br /> Date: Time: <br />