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CO0053565 (2)
Environmental Health - Public
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2500 – Emergency Response Program
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CO0053565 (2)
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Entry Properties
Last modified
1/5/2022 2:59:56 PM
Creation date
1/5/2022 2:53:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0053565
PE
2546
STREET_NUMBER
29933
Direction
S
STREET_NAME
LEHMAN
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
NEAR 25333035
ENTERED_DATE
3/18/2021 12:00:00 AM
SITE_LOCATION
29933 S LEHMAN RD
RECEIVED_DATE
3/18/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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CASTLE ANALYTICAL LABORATORY L0o o3c)cri CHAIN OF CUSTODY <br />Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 <br />Phone. 209 384-2930 - Fax: 209 500-1848 <br />Certificate No. 2480 <br />PAGE OF <br /> <br />_ <br />Customer: PG&E Stockton SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX soil(s) vapor(v) other (o) REQUESTED ANALYSES NUMBER OF CONTAINERS Method of Shipment: <br />CE( Address: 4040 West Lane BTEX/MTBEJTPH-GAS 8021/8015 TPH-DIESEL - 8015 TRPH 418.1M / SM5520C & F Oxy's / FOB / DCA by 8260 8260 - full list PCBs - 8082 IElectronic Deliverables (EDF) City/State/ZIP: Stockton, CA 95204 Notes: <br />Phone / FAX: (209) 942-1401 <br />Proj# / PO# /Global ID: <br />Report Attention: Alex Steele / Dave Larsen <br />Sampler Signature: <br />Sampler Printed: <br />Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION OBSERVATIONS/REMARKS <br />1 <br />13( k CZ4 3^ “6 :71 i.--• , <br />Printed Name Date Time Company Name <br />Total number of containers <br />Z. submitted to the laboratory .1‘,...e.„,___Si_gnature <br />Relinquished by: <br />.:..../c,, 04)1,- \_ Nt cL)314-2 \_ 3(..x;.. PI \,i_ e Turn <br />24 <br />48 <br />3 <br />5 <br />Around Time: <br />Received by: ' <br /> <br />114./ 0 CL'r-iI -\ LinA-A7 -5- 1.__2_A --) o o r,, r e,_1.--t.c OlAaLli rej,,. Hour I 1 <br />Relinquished by: Hour <br />Received by: Day I <br />Relinquished by: Day (Normal) 1 <br />Special: ><...„ Received by:
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