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ARCHIVED REPORTS_2016
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4400 - Solid Waste Program
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ARCHIVED REPORTS_2016
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Last modified
7/18/2020 9:57:16 AM
Creation date
7/3/2020 10:59:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
2016
RECORD_ID
PR0440005
PE
4433
FACILITY_ID
FA0004516
FACILITY_NAME
FORWARD DISPOSAL SITE
STREET_NUMBER
9999
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20106001-3, 5
CURRENT_STATUS
01
SITE_LOCATION
9999 AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\SW\SW_4433_PR0440005_9999 AUSTIN_2016.tif
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EHD - Public
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M=%, <br />Labor tOrleS Inc. <br />Environmental Testing Laboratory Since 1949 . <br />Chain of Custody and Cooler Receipt Form for 1609170 Page 2 of 2 <br />BC LABORATORIES INC. <br />COOLER RECEIPT FORM <br />Page Of' <br />Submission #: -U o <br />SHIPPING INFORMATION <br />Fed Ex ❑ UPS ❑ Ontrac ❑ Hand Delivery ❑ <br />BC Lab Field Service rk\ Other ❑ (Specify) <br />SHIPFING CONTAINER <br />Ice Chest EK None ❑ Box ❑ <br />Other ❑ (Specify) <br />FREE LIQUID <br />YES ❑ NO ❑ <br />Refrigerant: Ice Blue Ice ❑ None ❑ <br />Other ❑ Comments: <br />Custody Seals <br />None I� Comments: <br />/ <br />All samples received? Yes N,No o All samples containers intact? Yes No ❑ Description(s) match COC? Yes No ❑ <br />COC Received Emissivity: O,C15 <br />YES EINO Temperature: (A) <br />Container: PC Thermometer ID: Zdf DatefCimz_ I—tq /n <br />1 7 °C I t C ) °C Analyst snit <br />SAMPLE CONTAINERS <br />7 2 <br />SAMPLE NUMBERS <br />3 4 6 6 7 <br />0 9 70 <br />" T PE UNPRES <br />4oz / 8m; / 16oz PE UNPRES <br />2oz Cr" <br />T INORGANIC CHEMICAL METALS <br />CHEMICAL METALS 4oz / 8oz / 16oz <br />j�-T40=AMC <br />E <br />IT NITROGEN FORMS <br />PT TOTAL SULFIDE <br />2oz. NITRATE I NITRITE <br />PT TOTAL ORGANIC CARBON <br />" <br />PT CHEMICAL OXYGEN DEMAND <br />- <br />PA PHENOLICS <br />40ml VOA VIAL TRAVEL BLANK <br />40mi VOA VIAL V <br />7-7 <br />Z... <br />QT EPA 1664 <br />PT ODOR <br />RADIOLOGICAL <br />BACTERIOLOGICAL <br />40 ml VOA VIAL- 504 <br />T EPA 5081608/8080 <br />T EPA 515.1/8150 <br />T EPA 525 <br />T EPA 525 TRAVEL BLANK <br />40ml EPA 547 <br />40mi EPA 531.1 <br />3oz EPA 548 <br />T EPA 549 <br />T EPA 8015M <br />T EPA 8270 <br />3oz / 16oz / 32oz AMBER <br />ioz / 16oz / 32oz JAR <br />'OIL SLEEVE <br />y <br />'CB VIAL <br />'LASTIC BAG <br />PEDLAR BAG <br />FERROUS IRON <br />ENCORE <br />MART KIT <br />IUMMA CANISTER'" <br />7mments: <br />ample Numbering Completed By: <br />= Actual / C = Corrected <br />Date/Time. s Rev 20 07/24/2015 <br />19:1V1P0°0wa1dPertettllA8 DDC91FOaM919AMRECrev 207 <br />• <br />• <br />The results in this report apply to the samples analyzed in accordance faith the chain of custody document. This analytical report must be reproduced in its entirety. <br />All results listed in this report are for the exclusive use of the submitting party. BC Laboratories, Inc. assumes no responsibility for report alteration, separation, detachment or third parry interpretation. <br />Report ID: 1000470235 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 4 of 47 <br />
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