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COMPLIANCE INFO_2019
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0518738
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
6/23/2022 12:57:14 PM
Creation date
9/21/2020 10:28:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0518738
PE
2361
FACILITY_ID
FA0014111
FACILITY_NAME
CHEVRON STATION #212470/2222*
STREET_NUMBER
3400
STREET_NAME
MACARTHUR
STREET_TYPE
DR
City
TRACY
Zip
95376
APN
21306016
CURRENT_STATUS
01
SITE_LOCATION
3400 MACARTHUR DR
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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( t fGeneral COC MAI Work Order# <br /> McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd,Pittsburg,Ca,94565-1701 Tum Around Time;l Day Rush 2 Day Rush3 Day Rush STD Quote# <br /> Telephone:(877)252-92621 Fax:(925)252-9269 J-Flag I MDL ESL Cleanup Approved Bottle Order# <br /> \tom/ www.mccainpbell.com main([),mccampbell.eom Delivery Format: I PDF GeoTracker EDFJ I EDDI I Write fin(DW) I EQu1S <br /> Report To:M.Ibrahim Bill To: Analysis Requested <br /> Company:GHD Services Inc. <br /> Email:mohamed.ibrahim@ghd.comLD <br /> Alt Email: Tele: <br /> S S w C c o <br /> Project Name: 212470-Tracy Chevron Project#:11191863- r i ZZ <br /> Projeet Location:340acarthut rive,Tracy,GA PO# 11191863-2019-01 -+ v <br /> Sampler Signature: = -Z U Sc - _ _ - <br /> r <br /> Sampling <br /> SAMPLE ID dt <br /> Mattie Preservative x W. g <br /> Location 1 Field Point - - _ = W n ! e <br /> Date Time a <br /> e. a _ e. a R <br /> Z tQ <br /> X It Xk <br /> P 5 to t <br /> [off t <br /> MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate han or senous future health endangerment as a result of brief,gloved.open air,sample handling by MAI staff. <br /> Non disclosure incurs an immediate 5250 surcharge and the diem is subject In full legal liability for harm suffered.Thank you for o r understanding nd 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 ofeustody,MAI 11 efat me )y E200.8. Comments I Instructions <br /> Please rovi a an adecit4te volume of sample.lfthe volume is not sufficient for a MS/MSD a L.CSILCSD will be prepa •A is its place nd n ted ip the report. email results to: <br /> i qu' hed By Name Date Time ive l By/Cf mgA,Name Dalt Inmc mohamed.ibrahim@ghd.e <br /> S3 (-720m, <br /> cristina.alcon@ghd.com <br /> and jeff.cloud@ghd.com. <br /> Matrix Code:DW=Drinking Water,GW=Ground Water, WW-Waste Water,SW-Seawater, S-Soil,SL=Sludge,A=Air,WP=Wipe,O-Other n TLCITCLP as <br /> Preservative Code: 1=4°C 2=H.Cl 3=H,SO4 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None Temp f °C Initials <br /> Page 2-of 2 <br /> Page 87 of 88 <br />
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