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FIELD DOCUMENTS
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0508043
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Last modified
5/27/2021 2:02:02 AM
Creation date
5/24/2021 4:13:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
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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EHD - Public
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Lanier Laboratories 1046 ]i For Lanaster Laboratories use only P <br /> wtee�alttyrsasae xe Acct.#. ! ) Group#� I W 07 e Sample#: J q��� –7& <br /> Please print Anaiyses Requested SCR#: <br /> Site/Global ID'. <br /> Preservation Codes Preservative Codes <br /> Site Address: Q H =HCl T=Thiosulfate <br /> N =HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC d S=H2SO4 O=Other <br /> i U <br /> Consultant/Office: c5 ^' ❑J value reporting needed <br /> 113800 Watt Avenue,3Uife 20,SacraAento,CAHPP Risk Assessment Detection <br /> f j Limits <br /> Consultant Prj.Mgr.: NA } 7/� ElJ <br /> o N ❑ 0 0 ❑Chromatograms <br /> Consultant Phone#r: A Fax#: 0 c�� � <br /> U <br /> G#ll — 5 G o �l C> o o 2 U <br /> Sampler: �[� 4 N o 0 0 R <br /> Z cli �2 m <br /> Q co o C,co m <br /> Fiefd Repeat Tap Time Mew m o o W = = =co a CL r~ <br /> Point Name Matrix Sample Depth Year MonthjDayCollected Field Pt YM m_ Q Comments 1 Remarks <br /> d8 t 9 ► / 0 Y 7 x <br /> 1 r � <br /> Turnaround Time Requested{TAT)(check box) <br /> RP t hed`by: Date Time Received by: Date Time <br /> STD.TAF ❑ 24 hour ❑48 hour <br /> El 5 day El 72 hour El 4 day R uished by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Re ' ed by: Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: ceive by Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-CA Sample N Pre-Purge Sample UPS ed Other 1 $ <br /> R Rinsate Blank-CA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt �' �C° pH Custody 3eals Intact? o <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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