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COH34DNBK
Environmental Health - Public
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2500 – Emergency Response Program
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COH34DNBK
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Last modified
5/2/2023 1:20:18 PM
Creation date
5/2/2023 1:16:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COH34DNBK
PE
2546
STREET_NUMBER
6660
STREET_NAME
MAYBECK
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
16206001
ENTERED_DATE
6/17/2022 12:00:00 AM
SITE_LOCATION
6660 MAYBECK RD, STOCKTON
RECEIVED_DATE
6/17/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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General MAI Work Order # <br />Temp Preservative Code: 1=4°C 2=HCI 3=H2 SO4 4=1-1NO3 5=NaOH 6=Zn0Ac/NaOH 7=None <br />% , McCAMPBELL ANALYTICAL, INC. <br />1534 Willow Pass Rd. Pittsburg. Ca. 94565-1701 <br />Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />www.mccampbell.com main@mccampbell.eont <br />CHAIN OF C .P, 1 Y • , RD <br />15 <br />Turn Around Time. I Day Rush 12 Day Rush 3 Day Rush i STD • I Quote # <br />1-Flug / MD1. ESI. Cleanup Approv <br />i <br />Dry , g _ Bottle Order # <br />Delivery Fommt: PDF • GeoTracker EDI: EDD Write On (DW)1 1 Detect Summary • <br />Report To: Dewayne Liles 13111 To: NRC ENVIRONMENTAL Analysis Requested <br />Company: NRC ENIRONMENTAL SERVICES, INC. 1.,x NNW Range as Gas. Diesel, and Motor 00(8021/8015) — -r ...." <br />t7; a <br />.9 _ <br />i <br />71- <br />rz <br />.4 rim as Diesel (8015) + Motor Oil Without Silica Gel 11141 as Diesel (8015) + Motor Oil With Silca Gel 'lime 'L. .„, <br />— <br />si — — <br />li <br />6 <br />.4 <br />-• To ITotal Petroleum I lydrocarbons - Oil & Grease (1664 / 9071) With Silica Gel Itotal Petroleum Ilydrocarbons (418.1) With Silica Gel 15 <br />ii <br />_ <br />c, _ <br />007 <br />2 ,e7 IEPA 608 / 8082 PCB's ; Aroclors only c <br />.. <br />...2 <br />ri <br />— f•I .., <br />'1 <br />V) <br />:s. <br />= r- r. <br />- P. . <br />'1 <br />. <br />.e. IEPA 8270 SIM / 8310 (PAlls / PNAs) ICAM 17 Metals (200.8 / 6020)* g <br />i <br />.- <br />7.... Faylands Requirements 11.ab to filter sample for dissolsed metals analysis Address: 1605 FERRY POINT, ALAMEDA, CA 94501 <br />Email: DEWAYNE.LILES@USECOLOGY.COM Tele:510 671-4325 <br />Project Name:Alpine • -ilcopter Project ii: 180641 <br />Project Location:St i to n PO II <br />Sampler Signature: I / / <br />SAMPLE ID Sampling .2 <br />Location / Field Point -... matrix Preservative <br />Date <br />134-che 49.23.11A.r) 7H2Z- i V3c) 1 5 7 <br />5 a) Att.- sL3eL, I 5 -1 V <br />E.,-- W A U.— <br />72/2zj <br />7 12/2-2- / X: ik, I 1 X <br />W fAhel• LA-- 71/2/2-1-/2:Sc I_ 1 X <br />t•• Uhel-L.A.— 7//2/2z.j 3 • 0 2. I S I 4. <br />le-,0-1 Gs rnPa‘Lrg: 7/I 2/22- / 3: Osa. I S 1 <br />S 7 4 <br />mm clients MUST disclose any dangerous chemical known to be present in their ubmitt d samples in co icentrations that may cause III mediate harm or serious future heal Ii endangerment as a result of brief, gloved open air, sample handling b ' MAI taff <br />Non-disclosure incurs an immediate S250 surcharge and the client is subject to full legal liability for harm uttered. rhank you for your understanding and for allowing us to sort safely <br />. If metals are requested thr water samples and the water type (Matrix) is not specified on the chain of custody, MAI will delhult to metals by E200.8. Comments / Instructions <br />Please provide an adequate vol, me of sample. lithe volume is not sullieie it Ihr a MS/MSD a I.CS/I.CSD will be prepared in its place and noted in the report. <br />Rclinqui Hy / Ct fe i y Na c Date 'time Received 13y / Company Name Date Time <br />C-toruit,- L i dr CiSd litz 11:•5t, q‘ cte 743-22 1130 <br />*AI 4;64, Corcr,vo iii° • / iic.,E A iZi VC3r11 - -7".'frZ/Ze C—D A ‘' /1770 <br />...l <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 />Kon-riGt-p 5 Piqi ksuL-1- DU -710247-2. <br />Pi .1/ Ni(-frtilict, r//2 0 -r <br />Initials <br />. 1 Page 1 of <br />Page 28 of 29
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