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General CUC <br />MAI Work Order 4 120 � U <br />® McCAMPBELL ANALYTICAL, INC. <br />O1534 Willow Pass Rd. Pittsburg, Cu. 94565-1701 <br />WO Telephone: (87 7) 252-9262 / Par: (925) 252-9269 <br />www.mccamnhelLcom iiiain(eBnicceniphcll.coiii <br />CHAIN OF CUSTODY RECORD <br />Tun Aiound'rime:I Day Rush 2 Day Rush 3 Day Rush STD • Quote 4 <br />1-Rng. Hof ESL Cleanup Appnned Dr. Weicln Hottic Order 11 <br />Delivery Pumwt PDP OeoTracker EDP FF)D Write On (DW) Detect Summary <br />Report To: Tamara Woods Hill "fo: Macy Humphrey <br />Analysis Requested <br />Company:Terracon Consultants Inc. - Lodi <br />z <br />N <br />ay <br />M <br />Z01 <br />i1 <br />C <br />ED <br />ED <br />l:iii-,iil;tamara.woods@terracon.com <br />Alt Email:tony.mikacich@terracon.com Tele: 209-367-3701 <br />Project Name:JPM Project H: NA227026 <br />Project Location:1410 FREWERT RD. LATHROP PO .`.= <br />Sampler Signature: <br />SAMPLE ID Sampling <br />Location / Field Point Matrix Prcre c;uivc <br />Date _ <br />GW -1 / TRAILER S 1 water None <br />11! <br />GW -1 /TRAILER 2 water neo<" <br />• <br />Trip Blanks 2 water <br />GW -2 / RESIDENCE t 050, 1 water None <br />GW -2 / RESIDENCE 1 os 2 water mar«b,e <br />• <br />Trip Blanks 2 water <br />NIAI elienu \1I1ST disclose any dangerous ehamiculs known to be present in Ihcir.vubmitted samples in enncenirutiuns thnt mo}'vause imnudinte hums nr serious future health endungemunt us a result of brief, glovatI, open air, sample handling by MA1 stuff. <br />Non-dixlo.ure iucun an immedUe $250 surcharge and the hent is subject w full legal liability for h:um ,offered. Thank you for your and— tauding: d fou allowing tax to a ,k -fcly. <br />• If metals arc requested for seater samples and the waler type (Matrix) is not specified on the chain of custody, ALAI kill default to metals by 1:200.8. <br />Continents % Instructions <br />Please provide an adequate volume ol'sonlple. If the volume is not sunicient for a NIS/NISD a LCSiLCSD will he prepared in its place and noted in ilia report. <br />Relinquished 8,v / Company Name Data Time Rceeived By / Company Num, Dale Time <br />�� 2. <br />Matrix Code: DW—Drinking Water, GW=Ground Water, WW=Wastc Water, SW=Seawater. S=Soil, SL=.- ldgc, A—Air, WP=Wipe, O -Other <br />Preservative Code: 1=4°C 2 -HCI 3=H2SO4 4—HN01 5=NaOH 6—ZnOAciNaOH 7=None Temp 2 °C Initials 1-�-V <br />Pagpage 140", <br />