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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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8 3O L 0213d <br /> General COC MAI Work Order# <br /> ® McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> O1534 Willow Pass Rd.Pittsburg,Ca.94565-1701 Tum Around Time:I Day Rush 2 Day Rush 3 Day Rush STD • Quo[C# <br /> WO Telephone:(877)252-9262/Fax:(925)252-9269 1-Flag/MDL ESL • 1 Cleanup Approved I I Bottle Order# <br /> www.meeampbell.eom mainAmeeampbell.eom Delivery Format: I PDF • GeoTmck-r EDF EDD writ-On(Dw) EQu1S <br /> Report To:Rick Day Bill To:Geocon Analysis Requested <br /> Company:Geocon <br /> Email:day@geoconinc.com <br /> All Email:beadle@geoconinc.com Tele:925-371-5900 In <br /> Project Name:Manteca Firing Range Project#£8857-02-02 <br /> Project Location:Monte ,CA pp f� <br /> Sampler Signature: CO U O `>1 E E r 00 <br /> amlin <br /> SAMPLE ID P g Ci aC t6 2L In <br /> Is Matrix Preservative t0 ++ a) <br /> Location/Field Point Date Time tt (D C N0 O _C C Q C Q <br /> -J Q Q U U U H N U 1- M <br /> 3/1 /17 1 S <br /> 3/1 /17 1 S <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> 3/16/17 1 S 1 <br /> MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate harts or nations future health endangerment as a result ofbdef,gloved,open air,sample handling by MAI staff. <br /> Non-disclosure incurs an immediate S250 surcharge and the client is subject to full legal liability for harm suffered.Thank you for your understanding and for allowing us to work safely. <br /> -If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will default to metals by E200.8. Comments/Instructions <br /> Please provide an adequate volume ofsample.Ifthe volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared in its place and noted in the report. S6trrlPligq 1514AG11�)O[a� <br /> Relinquish y/Cmpany Name Date Time Received By/Company Name Date Time y,- 3I/.TJJ�LM�/ 3(v/�/� <br /> z3z 2 —c 3 /7 17 1232 'V <br /> Matrix Code:DW=Drinking Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S=Soil,SL=Sludge,A=Air,WP=Wipe,O=Other <br /> Preservative Code: I=4eC 2=HCl 3=H2SO4 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None Temp °C Initials <br /> Page—of <br />
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