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CO0055419
Environmental Health - Public
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LONE TREE
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2500 – Emergency Response Program
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CO0055419
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Entry Properties
Last modified
8/3/2023 10:02:06 AM
Creation date
8/3/2023 9:55:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0055419
PE
2546
STREET_NUMBER
23214
Direction
E
STREET_NAME
LONE TREE
STREET_TYPE
RD
City
ESCALON
Zip
95320
APN
NEAR 22905003
ENTERED_DATE
12/8/2022 12:00:00 AM
SITE_LOCATION
23214 E LONE TREE RD
RECEIVED_DATE
12/8/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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CASTLE ANALYTICAL LABORATORY <br /> CHAIN OF CUSTODY <br />Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 <br />ELAP Certificate No. 2480 <br />PAGE OF <br /> <br />• <br />r I Iln le. VA-0U) ...MPI-Z-JJV - I <br />Customer:i-76.ii /444Z?9,, SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX Roil(s) liquid(I) vapor(v) other (o) REQUESTED ANALYSES NUMBER OF CONTAINERS Method of Shipment: <br />Address: p3-1-7XI1TBE/TPH-GAS 8021/8015 TPH-DIESEL / MOTOR OIL - 8015B TRPH 418.1M / SM5520C & F Oxys / EDB / DCA by 8260 8260 Volatiles- full list PCBs - 8082 Electronic Deliverables (EDF) City/State/ZIP: Notes: <br />Phone / Email: <br />Project# / PO# / Global ID: 3/f4 itee.4 5{; _5 <br />Report Attention: <br />Sampler Signature: <br />Sampler Printed: 4-Aak i ( Z'kti7 4-- <br />Lab ID# SAMPLE ID DAT, • TIME DESCRIPTION/LOCATION OBSERVATIONS/REMARKS <br />5tA)5 7F/ --' zza.) 5.4e,, 3 K <br />71-(4-) /4i•-.5 ')<K <br />Si nature Printed Name D g Time Company Name <br />Total number of containers <br />submitted to the laboratory <br />Relinquished by: bilitMiX) z'',/t4 iz , 7.2 j)i' <4 (— <br />Turn <br />24 <br />48 <br />3 <br />5 <br />Around Time: <br />Received by7- <br />— V <br />0.,„S (z( afr(/.7-.1 g7/10 (-4,_SV---(4_ Hour ,,-e-.1-----. <br />Relinquished by:i <br />1-17( e--1 / r--- <br />Hour I <br />Received by: Day <br />Relinquished by: Day (Normal) I <br />Special: Received by:
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