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SITE INFORMATION AND CORRESPONDENCE (2)
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0508043
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SITE INFORMATION AND CORRESPONDENCE (2)
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Last modified
5/24/2021 6:49:44 PM
Creation date
5/24/2021 2:36:59 PM
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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SJGOV\dsedra
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EHD - Public
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Pipeline ' / ' • / <br /> Lwcaster Umbies 0902 For Lancaster Laboratories use only {} (J ' <br /> 1M�Tg[ tyisasc►e c? Acct.M 13 Group# of VJ�� Sample M �7JJ 57 — <br /> Please print Analyses Requested SCRM <br /> SitelGlobal ID: NityVA5 <br /> IWAP SAW I S 45 9 33 Preservation Codes Preservative Codes <br /> 355(n Sat�Wl 9d I�QYodkS CA Q N=HNO3 B=NaOH Site Address: , <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIL S= H2504 O=Other <br /> W U <br /> Consultant/0,fine: ❑441 Alberto Way,Suite B,Los Gatos,CA 95032 0 ❑J value reporting needed <br /> �/ <br /> X318100 Watt Avenue,Suite 210,Sacramento,CA 95821 0 ,,,t ❑ "' ❑LimitsRisk Assessment Detection <br /> Consultant Prj.Mgr.: C'CHAP �Y}Yl1 S o �` g <br /> L o .� 0 <br /> 0 ❑Chromato rams <br /> Consultant Phone#: C'7W)�'��(0 Fax#:� �[9� �1' '� 3�' a? co <br /> Sampler: L 5'tl) G` >" o Z m N <br /> iZ m o0 <br /> Field Repeat Top Time Nene 12o .a w < s co <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN 0 U H m a a <br /> RA <br /> -T K�j <br /> , - Comments!Remarks ID � Silica �lL*w <br /> tark y 7W M:,Man <br /> Mini NIA CCQ 11 153p N <br /> H(-(Vt 1 It 45 K 1 k K X r1mi)5 ,04[y) <br /> ID X k K S�titSD +0-h&I a_r <br /> Turnaround Time Requested(TAT)(check box) d by: Date Time Received b . Date Time <br /> XSTD.TAT El 24 hour El 48 hour <br /> ❑ 5 day El 72 hour El 4 day Relinquishe a e Time Recely Date Time <br /> Matrix Values Repeat Values Relinquished by: ate Time Received by: ate Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Received by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample } <br /> T Trip Blank-QA Sample N Pre Purge Sample UPS x Other tf d rat <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temper1tuNMrPUpon Receip Co pH Custody ea to Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />
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