CHAIN OF CUSTODY RECORD
McCampbell Analytical, Inc.
1534 Willow Pass Rd. / Pittsburg, Ca. 94565-1701
www.mccampbell.com / main@mccampbell.com
Telephone: (877) 252-9262 / Fax: (925) 252-9269
TURN AROUND TIME: RUSH
1 DAY
GeoTracker EDF
Write On (DW)
PDF
EDD
Effluent Sample Requiring “J” flag
EQuIS
UST Clean Up Fund Project
5 DAY
10 DAY
; Claim #
Lab to Filter sample for Dissolved metals
analysis
Metals (200.8 / 6020)***
LUFT 5 Metals (200.8 / 6020)***
CAM 17 Metals (200.8 / 6020)***
EPA 8270 SIM / 8310 (PAHs / PNAs)
EPA 525.2 / 625 / 8270 (SVOCs)
EPA 524.2 / 624 / 8260 (VOCs)
EPA 515 / 8151 (Acidic Cl Herbicides)
EPA 507 / 8141 (NP Pesticides)
EPA 608 / 8082 PCB’s ; Aroclors only
EPA 505/ 608 / 8081 (Cl Pesticides)
Total Petroleum Hydrocarbons (418.1)
Total Petroleum Oil & Grease (1664 / 5520
E/B&F)
TPH as Diesel (8015)
Other
Sludge
Air
Soil
Sea Water
Drinking Water
Waste Water
Time
Ground Water
Location/
Field Point
Name
Date
# Containers
SAMPLE ID
METHOD
PRESERVED
MATRIX
SAMPLING
BTEX & TPH as Gas (8021/ 8015 ) MTBE
E-Mail:
Project Name:
Purchase Order#
Other
Tele: (
)
Project #:
Project Location:
Sampler Signature:
3 DAY
Analysis Request
HNO3
Bill To:
HCL
Report To:
Company:
2 DAY
**MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate harm or serious future health endangerment as a result of brief, gloved, open air, sample
handling by MAI staff. Non-disclosure incurs an immediate $250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing us to work safely.
*** If metals are requested for water samples and the water type is not specified on the chain of custody, then MAI will default to metals by E200.8.
Relinquished By:
Date:
Time:
Received By:
Relinquished By:
Date:
Time:
Received By:
Relinquished By:
Date:
Time:
Received By:
ICE/tº_______
GOOD CONDITION______
HEAD SPACE ABSENT_______
DECHLORINATED IN LAB_______
APPROPRIATE CONTAINERS_______
PRESERVED IN LAB______
COMMENTS:
VOAS O&G METALS OTHER
HAZARDOUS:
PRESERVATION_______________pH<2__________________