Laserfiche WebLink
State of California <br />Calporn a Env'ronm nt l P t ction Aeencv <br />Department of Toxic Substances Control <br />ENVIRONMENTAL CHEMISTRY LABORATORY <br />1. Authorization Number <br />ECL No.: <br />SAMPLEANALYSIS REQUEST <br />_ _ 2, page <br />(L O <br />To 1 of 1 <br />3. Requestor.(to Rerelve Results) a. Name: Trevor Anderson <br />_ <br />4. Project Name (if applicable): <br />b. Address: 8800 Cel Center Drive <br />_no -en �umbal <br />Stockton Propeller, Inc. <br />- -- — -- <br />S_acramenro, CA 95826 _ _ <br />fcN.:we.+Vl <br />a Phone: (918)045-3630 (ereaamlml tl. Fax: <br />_ <br />preeca]efinn <br />STAT Level: 2 <br />a. Email: trevor.ande_rs_o_n_ _ @dtsc.ca.gov <br />-- — <br />6.Sampling Information: a. Date/1'ime Sampled: <br />06/03/21 (mm/dd/yy) 7. Codes (4e1au14m araoa ,nna<munnelq;;mael <br />b. Location: EPA ID No. N/A <br />(#:## AMIPM) a.Unh <br />___ <br />Site: Stockton Propeller_ Inc_ <br />xwue.orc uc,y„m,; mra.uy.w�:ISAcI <br />b. Project <br />-_ ___ ID DItSC91524238 <br />Address: 2478 Wilcox Road <br />(saex nombel C. Activity ID <br />Stockton, CA 95215 <br />_36322_ _ <br />tub. ami. a4) d. MPC a11A--- <br />GPS-Lat: _ _ GPS -Long: <br />9 <br />_- e. County 39 -San Joaquin <br />GPS -Alt: _GPS -Depth: <br />.-- —_--. _ <br />8. Samples: <br />f. Number of <br />a.ID b. Collectors No. c. ECL No. d. Matrix <br />e. Container Size containers . Preservative / Field Information <br />SPoF6_ Ltgr,w <br />% ea I_ <br />_ _ <br />CLw'9 <br />-�� _ <br />6 <br />— — <br />9. Analysis Requested: Enter sample IQs and sam le ID ran ea ea anted <br />b commas. For exam le, 1J, 5-7, 9 <br />a. Inorganic Analysis Sam les 10 <br />b. 0 ante Anal is Sam Is s ID <br />F <br />I <br />I -IR qq' <br />Other Metals. Chromium Vl <br />-- - - - - <br />s.TCLPAnal sis <br />d. Other Analysis <br />..- _-7�mpl"Mna"M$ <br />Fish Bioassay (Title 22, Fish <br />e. Comments for MultipPriority: <br />10. Analysis Objective:cation11. <br />Detection Limit Re <br />12. Su lememal Requests: Enter sample IDs as described in Item 9 <br />13. ECL Lab Remarks: <br />Desired Anal is Sam les ID <br />L <br />0 <br />Initials <br />� <br />A <br />e <br />14. Chain of Custmi : <br />a. f3E�oR aAndritoo_ <br />Signature Inclusive Dares o/ Cuatotl <br />b.fm9c6A'e Mc4LkA.e1.0 <br />its /-SOIL, to 6(31ua <br />131202t to <br />to <br />0 <br />- - - - ---- -- - -- - - - - <br />e. -- <br />ro <br />- - - <br />C <br />- -- -- - --- -- - <br />f. <br />to <br />- to <br />070140.W rev 01]29rzan mxxn n—im, t <br />ro <br />a9smen OlScer Make Pholocopres for Your He <br />