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SR0085800_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0085800_SSNL
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Last modified
9/30/2022 8:29:54 AM
Creation date
9/30/2022 8:23:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0085800
PE
2602
STREET_NUMBER
12960
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00727022
ENTERED_DATE
9/20/2022 12:00:00 AM
SITE_LOCATION
12960 E JAHANT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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General COC <br />MAI Work Order # <br />V66 6 <br />\ (j� McCAMPBELL ANALYTICAL, INC. <br />� �. <br />1534 Willow Pass Rd. Pittsburg. Cat 94 565-1 70 1 <br />�O Telephone: (877) 252-9262 / Pax: (925) 252-9269 <br />www.mccampbell.com maintnqmceampbell.conl <br />CHAIN Or CUSTODY RECORD <br />rnrn ;%round I nnr I Dui f2U.h 2 Day Rush + Dae hush S rn • Quote # <br />)-ring/ MDI. l til Cleanup Approt ed Dry Weight 13ottle Order i <br />I),IitmFonnm 1'I,I (;co I racker EDI I 1,o\\'riteOntDwl DcIeclStu„n,ur. <br />Report I o: Daniel Krarner Bill To: Daniel Kramer <br />AmIk li" Requested <br />Company: Petralogix Engineering <br />_ <br />r� <br />N <br />LlJ <br />a- <br />U <br />m <br />CD <br />O <br />Cl) <br />W <br />Z <br />C1)Location <br />O <br />Z <br />Ismail: dkramer@petralogix.com <br />\It Eiiiail:tscheftner@petralogix.com I ele: 209-770-0731 <br />Project Nanic: SSS/NLS - 12958/12970 E Jahant Road Prule�t #: <br />Project Location: 12958/12970 E Jahant Rd, Acampo PO <br />Sampler SiL,natur— <br />SAMPLE 1D <br />Field Paint <br />�am?lin�� <br />I <br />_ <br />- <br />-0 <br />Matrix <br />Prescnau.� <br />I):Ilc <br />lime <br />Well <br />D,;•,/ <br />AS -16 1, <br />MAI clients MUST disclose any dangerous chemicals (mown to be present in their submitted samples in concentrations that may cause nnn,ediate Kann or serious haurc licalth endangerment as a result of briet, gloved, open air, sample handling toy N1AI slat i <br />Non -disclosure incurs an immediate 5250 surcharge and the client is subject to full legal liability for hart suffered. Thank you for your understanding and for allowing us to work safch. <br />* If metals are rcqucsted for water samples and the water type (Matrix) is not specified on the chain of custody. MAI will default to metals by E200.8. <br />Comments! Instructions <br />Please Provide an adegUaue colun,e of sample II IIIC tulun,c P, not sullicient I'm a N1S/MSU .i LCS/LCSD kill he Prepared in us Pla,ec Luul noted u, the report <br />Relinquished B\1 /Company Name Date Time Rc rvcd By / mpany Name Datc Iline <br />2 -1 XIx <br />Matrix Code: DW=Drinking Water, GW=Ground Water, \\'W=Waste Water. SW=Seawater, S=Soil. SL SludLc. \ -air. WP=Wipe, O=Other <br />Preservative Code: 1=4°C 2=HCI 3=H,SO4 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None Temp °C Initials <br />Page __ of _ <br />Page 9 of 10 <br />
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