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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0540433
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Last modified
7/27/2020 9:10:25 PM
Creation date
7/27/2020 4:03:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0540433
PE
2953
FACILITY_ID
FA0023104
FACILITY_NAME
FORMER MANTECA POLICE FIRING RANGE
STREET_NUMBER
2516
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
24131044
CURRENT_STATUS
01
SITE_LOCATION
2516 W YOSEMITE AVE
P_LOCATION
04
QC Status
Approved
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EHD - Public
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General COC MAI Work Order# <br /> O® McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd.Pittsburg,Ca.93565-1701 "I'um Around Tinne:I Day hush 2 Day Rush ;Day Itnsh SI'1) • QUUIC P. <br /> WO Telephone:(877)252 /Fax:(925)252-9269 1-Flag r MDL HSI. • Cleanup Approved Bottle Order# <br /> tS9RV n1CCa1»pl)CII Cem Iilant(tL111CCanlDhCll Cont Delivery Formal: PDF Gco'rmck<r FDF HDD \\'rile On IDII'1 GQuIS <br /> Report To:Rick Day Bill To:Geocon Analvsis Requested <br /> Company:Geocon <br /> Entail:day@geoconinc.com <br /> All EoIDil:beadle@geoconinc.com -Pele:925-371-5900 U) <br /> Project Name:Manteca Firing Range Project#f8857.02-02 C0 <br /> Project Location:Manteca,CAPp# <br /> O CD <br /> Sampler Signature: „ CO O j .-� E ti 0 • <br /> SAMPLE ID Sampling ° -o E C E Q .� 10 <br /> Matl'jx Preservative N :i+ N -O .1] O. (p U _ <br /> Location/Field Point C y M O O <br /> Dale 'rime JF- <br /> 3/16/1719— <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S - <br /> 3/16/17 S 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 Ian 11 S 1 x <br /> 3/16/17 1 S 1 <br /> 3/16/17 p 1 S 1 <br /> (o 3/16/17 b 1 S 1 . <br /> 3/16/17 'L) 1 S 1 X <br /> MAI clivus MUST disclose any bangerous chemicals known nt he present in their submitted samples in emmenuatimu that may cause immediate hams or scrims Poore henbh enbangennic as a esi ll of brief.gioced,open air,sample hurdling by MAI stag <br /> Non-disclnsnre incurs an immediate S250 sundials,and the client is ndij«t to fall legal flibila,for harm suffered.'I hank you our your wWennndiug and for allowing its to work safely. <br /> If metals arc requested I-or water samples and the water t)pe(Matrix)is not specified on the chain ofcustody.MAI will default to mclals by F200.8. Cam menu/Instructions <br /> Please provide an adequate volume ofsamplc.If the volunm is not sufficient fora MS/MSD a I.CS/LCSD will be prepared in its place mid noted in the report. <br /> Relin ished B), nm w Nano Date Time Received By/Company Name Date Timc <br /> C /Lt dC -6 -(7 a 1b Il s� <br /> Matrix Code: DW-Drinking Water,GW=Ground Water,WW=\Paste Water,SW=Seawater,S=Soil,SL=Sludge,A=Air, WP=Wipe,O=Other <br /> Preservative Code: 1=4°C 2=HCI 3-1650.1 4-11NO3 5=Na011 6=Zn0Ac/Nn011 7=None Tentp aC Initials <br /> -ZL <br /> Page L of <br /> Page 41 of 44 <br />
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