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Environmental Health - Public
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2900 - Site Mitigation Program
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PR0508043
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/24/2021 7:04:54 PM
Creation date
5/24/2021 11:28:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0508043
PE
2960
FACILITY_ID
FA0007905
FACILITY_NAME
CHEVRON PIPELINES
STREET_NUMBER
35500
STREET_NAME
WELTY
STREET_TYPE
RD
City
VERNALIS
Zip
95385
APN
25526003
CURRENT_STATUS
01
SITE_LOCATION
35500 WELTY RD
P_LOCATION
99
QC Status
Approved
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Hislotical Pipeline PortfolioAnolysisRequestlChoin1Custody <br /> +L.axaster Todds 0771 For Lancaster Laboratories use only r1 <br /> Where gja{rtyrsasner", Acct.#: �1 L4 13 Group#IV ✓?_.Vq Sample#: 5()��aD—D3 <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal ID: 11PYr1@lls riD S�/SLDiG�D flL41735 Preservation Codes Preservative Codes <br /> Site Address: 3f25 5�ll��iyqei' � y �l� H= HCl T= NaOH 1 t N= HNO3 B= NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC S= H2SO4 O=Other <br /> to U <br /> L <br /> Con sultantlOffice: ©401 Alberto Way,Suite B,Los Gatos,CA 95032 C 11 <br /> - ❑J value reporting needed <br /> X3800 Watt Avenue,Suite 210.Sacramento,CA 95821 o ❑ �I ❑HPP Risk Assessment Detection <br /> �►�" Q,� U Limits <br /> Consultant Prj.Mgr.: 5yIrlb eAVUS J <br /> 1 p o o ❑Chromatograms <br /> Consultant Phone#: 0(el Fax#:Cf((1� '3�35 00 co <br /> � o <br /> o <br /> Sampler: = o <br /> O Z Nciv n <br /> Q °° o <br /> Field Repeat Top Time Newo o Li = _ <br /> Point Name Matrix Sample Depth Year Month Day Collected Field PtY1N (D l*— <br /> OAa EL <br /> P, N A- -A O C) Comments 1 Remarks <br /> MW A N� � e nl *K � -t IiCa � c�ca� <br /> v'P a +�c�e4ec +ori <br /> b <br /> 4-H <br /> Relin s by: Date Time Received by: Date Time <br /> Turnaround Time Requested (TAT)(check box} L <br /> ,STD.TAT El24 hour El 48 hour 3-67 .�/'q <br /> ❑ 5 day ❑ 72 hour El 4 day Relinquish by: Date Time Received b Date Time <br /> Matrix Values Repeat Values Relinqulshed by: Date Time Retc!b Date Time <br /> S Soil D Duplicate sample Relinquishe mmercial Carrier: Rec ived b `;; Date Time <br /> W Surface Water or Groundwater T Triplicate Sample / <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt j C. pH Custody feals Intact? No <br /> exle r'' <br /> n/ Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1114105 <br /> le Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />
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