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COMPLIANCE INFO_2020
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0538714
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COMPLIANCE INFO_2020
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Last modified
11/9/2020 2:15:13 PM
Creation date
10/9/2020 2:41:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0538714
PE
2220
FACILITY_ID
FA0022229
FACILITY_NAME
California Department of Fish and Wildlife
STREET_NUMBER
2109
STREET_NAME
ARCH AIRPORT
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
17731020
CURRENT_STATUS
01
SITE_LOCATION
2109 ARCH AIRPORT RD STE 100
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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2 ci--n <br /> Gcncral COC MAT Work Order# -U U43 5� <br /> 7 MCCAMPBELL ANALYTICAL, INC. CIiAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd.Pittsburg,Ca.94565-1701 Turn Around Times l Day Rush2 Day Rush 3 Day Rush STD • 1 Quote# <br /> Telephone:(877)252-9262/Fax:(925)252-9269 J•Flagi MDL I ESL Cleanup Approved Dry Weight Bottle Order it <br /> Nvww.mecampbell.com maini<u`,mccatnp6ell.c Delivery Format: I PDF GeoTracker EDF I ED➢ I Write On(DW) Detect Summary <br /> Report To: Kathy Hieb Bill To:See Below Analysis Requested <br /> Company:California Department of Fish and Wildlife o 5 <br /> Address:2109 Arch-Airport Rd. Suite 100. Stockton, CA 95206 s - - - _' <br /> Email:kathy.hieb@wildlife.ca.gov Tele:209-234-3484 �= n Q a a Z: E <br /> o 0 <br /> Project Name: Project# Ir <br /> : V o 5 A i 6 M. E o r G <br /> CU <br /> _ . _ <br /> Project Location: PO# LO <br /> x U <br /> Sampler Signature: `� i>✓ .---, x G �, v ;� co <br /> '� y M <br /> r O 00 <br /> SAMPLE ID Sampling = __ �- c S z N H o 5 c 4 <br /> Matrix Preservative o rt �% C. •% -'G� ?+ = ✓r b `, . <br /> Location/Field Point <br /> Date Time U <br /> W <br /> i; w U <br /> } Tank A (3,000 gallon tank) 04/8/2020 10:29am liquid A <br /> Tank B (1,000 gallon tank) 4/812020 10:51am liquid <br /> Ki I <br /> MAI clients MUST disclose any dangermos chemicals known to be present in their submitted samples in concentrations that may cause immediate hums or serious fiuure health endangerment as a rewk of brief,gloved,npen air,sample handling by MAI staff. <br /> Nan-disclosure incurs an immediate 5250 surcharge and the client is subject to full legal liability for liann suffered.Thank you for your understanding and for allowing us to work safely. <br /> *If metals arc requested for water samples and the nater type(Matrix)is not specified on the chain of custody.MAT will default to metals by E200.8. COnrmettt3 I Instructions <br /> Please provide an adequate volume of sample,If the volume is not sufficient fora NISIMSD a LCSILCSD will be prepared in its place and noted in the report. <br /> Relinquished By/Company Namc Datc Time Received By/Company Name Date 'lime <br /> 2-OZ- <br /> 41 A U <br /> a tx ode:DW-DrinkingWa er,GW=Ground - , - - <br /> Preservative Code: 1=4°C 2=HCl 3=142SO4 4=HNO3 S=NaOH 6-ZnOAc/Na0H 7=None TC1111) �C Initials <br /> Y Page—of <br /> Page 8 of 9 <br />
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