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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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SJGOV\dsedra
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EHD - Public
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Histotical Pipeline ' • 1 1AnalysisRequestlChainofCustody <br /> +Lancastler Laboratodes 1049 }� i For Lancaster Laboratories use only <br /> VlAwegjaityisascieAcct.#: 1 f I Group# j QS;9L2 d Sample#: 5 V T y V�3 <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal ID: Preservation Codes Preservative Codes <br /> r�� �k H=HCI T=Thiosulfate <br /> Site Address: N =HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAI S=H2SO4 O=Other <br /> Consultant/Office: d JG� ❑J value reporting needed <br /> '6 HPP Risk Assessment Detection <br /> ❑3800 Watt Ave nue,Snuiitte,, Sacramento,CA 95821 0 ❑ <br /> Consultant Prj.Mgr.: �,�VT if J7 h a'1 l� U ❑ > ❑ Limits <br /> ��/� p o N o ❑Chromatograms <br /> Consultant Phone#: e15fi�57 J— A_5�Fax#: � co o <br /> o <br /> o o <br /> ` Sampler: " t r��?i'j+J�� <br /> g Z m co <br /> N o <br /> Field Repeat Top Time New N o �° w = co <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN 0 mIL <br /> t, Comments 1 Remarks <br /> 7 <br /> Re' uished b : Date Time Date Time Received b <br /> Turnaround Time Requested(TAT]{check box} ✓ ✓ y <br /> TD.TAT ❑ 24 hour ❑48 hourB <br /> C1 5 day El 72 hour El 4 day e' ishe 'y Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by' Date Time <br /> S Soil D Duplicate sample Relinquished b ercial Carrier: Re iv 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 a 1 <br /> R Rinsate Blank-4A Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temp Up <br /> perature on Receip s -;L�° pH ody Seals Intact? No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1/14/05 <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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