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General COC MAI Work Order # ixto p7/e
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<br />,a, McCAMPBELL ANALYTICAL, INC.
<br />Pass Rd. Pittsburg, Ca. 94565-1701
<br />44.
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<br />(877) 252-9262 / Fax: (92 1 .:.•••
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<br />maindih t ' -7. .1111
<br />CHAIN OF CUSTODY RECORD
<br />1534 Willow urn Around Time:1 Da Rush y -Xs 2 Day Rush 3 Day Rush STD Quote if
<br />KW)salf Telephone: J-Flag / MDL ESL Cleanup Approved
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<br />Summary[ w‘vw.mccampbell.com Delivery Format: PDF GeoTracker EDF EDD Write On (DW) Detect
<br />Report To: Bill To: Analysis Requested
<br />Company: Y,4.,-c.. A/. jtv , Multi Range as Gas, Diesel, and Motor Oil (8021/8015) Time BTEX & Tpii as Gas (8021/ 8015) naBE s .
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<br />'A C5 = .p. Trii as Diesel (8015) + Motor Oil With SiIca Gel Total Oil & Grease (1664 / 9071) Without Silica Gel Total Petroleum Hydrocarbons - Oil & Grease (1664 / 9071) With Silica Gel Total Petroleum Hydrocarbons (418.1) With Silica Gel .
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<br />-,: 1EPA 608 / /1082 PCB's ; Aroclors only EPA 524.2 / 624 / /1260 (VOCs) EPA 525.2 / 625 / 8270 (SVOCs) EPA 8270 SIN1 / 8310 (PAH% / PNAs) CAM 17 Metals (200.8 / 6020)* O' , e ..., -
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<br />4. Bay landsRequirements f. Lab to filter sample for dissolved metals analysis =
<br />Address: "4 c,-s \ ..N3 „v ,„" d 4- 5 1-ac ‘co'l CA'
<br />Email: /y1;ch/, AncAer-50 ,1 (6,1 4, r-,d, .6c.,..-ATele: /4 L./2c 1 / .2 2-
<br />Project Name: A c e.,, , -.% 4-r p„ a Project #:
<br />Project Location: PO if
<br />Sampler Signature: _....72----ic,n AN- (
<br />SAMPLE ID
<br />Location / Field Point
<br />Sampling ,.•
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<br />Matrix Preservative
<br />Date
<br />Pe,I.A ce/1 4-/- 14111 /6 ,30
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<br />MM clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cquse immediate harm or serious fun re heal Is endangerment as a result of brief, gloved open air, sample handling by MAI staff
<br />Non-disclosure incurs an immediate S250 surcharge anti the client is subject to full legal liability for hams suffered. Thank you for your understanding and for allowing us to work safely.
<br />" If metals are requested for water samples and the water type (Matrix) is not specified on the chain of custody. MAI will default to metals by E200.8. Comments' Instructions
<br />Please provide an adequate volume of sample. If the volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared in its place and noted in the report.
<br />Relinquished By! Company Name Date Time Received By / Company Name Date Time
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<br />i // P75 ) H Zj Nil 4 el' Ar t1/1"" 7- -7
<br />Matrix Code: DW=Drinking Water, GW=Ground Water, WW=Waste Water, SW=Seawater, S=Soil, SL=Sludge, A=Air, WP=Wipe, 0=Other
<br />Preservative Code: 1=4°C 2=HCI 3=H 2 SO4 4=HNO3 5=Na01-1 6=Zn0AcfNa01-1 7=None Initials
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