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HomeMy WebLinkAboutCT 04-10; POINSETTIA PLACE; CHLORNIATION SAMPLE; 2012-06-12MATT j CHLOR, INC. . 4107 NORTH ARDEN DRIVE EL MONTE, CALIFORNIA 91731 Ph: (626) 443-5034 (619) 542-0155 (San Diego Area). Fax: (626) 443-2226 %Website:, www.mattchlor.comt• E-mail: service@mattchlor.com ( Service Order M. 14643 Compwy Name: Schilling Corjioraiion Tethniaan: Mark Aurelio Date: Technician:06/12/12, Tuesday Payment Terms: Appointment Confirmed With: Net 30 Days John Time: PO4* AND/OR JOB# 9:00AM Job #: 11095 Po #: 6229 Code Cost- 015-60-n08 Date & Thise Appobitment Was Confinned 06/11/12 2:32PM MeetinAd&ess: Service Location: Take 5 Freeway And Get Off On Poinsettia Lane Poinsettia Lane & Cassia Road Go EastUntil You Get To Cassia Road Carlsbad, Ca 92011 Thomas Guide: 1127D5 \ Jcth Called In By: Phone Number (office): Phone Number (cell): Fax Number: E-Mail Requester): John-- • 619-792-1612 619-579-3733 schristoschiiIing-paradise.com Dave Valdez Contact At Job: 619-719-2202 Cdi Number: Office Number: E-Mail (Contact at Job Site): Day 1: ZhIorinate, 500 feet of 12 inch Day 2: Dechlorinate "ONLY" 500 feet of 12 inch I. t Chlorine Concentration (ppn) Requred For Chlorination JpbA nly: PPM? - High Ctor1ne Residual:' Chlorine Residual (after 3 HRS /24 HRS ! OR - HRS) ' CIRCLE THE ONE THAT .AIPLIES OR UST NUMBER IF 18-OTHER THAN 3 OR24 HOURS ( Low Chlorine Residual, (After DechhrinatIon): i I I . - Also Ilst6tikiilne residual at every sample location on chain Chlorine Residual (prior to water sanplo collection):, \of custody, this way the laboratory can Include on Final AdditIona Se ce"DUes & Speia1Inst,tcthns: Laboratory Report 11 DESCRIPTION OF WORK COMPLET D:(L Io vtJ- c) SX .p-t 4 LL C.vvc ENDATIONS/CAUTIONS: D HEREBY ACKNOWLEDGES THE WORK DESCRIBED ABOVE HAS BEEN COMPLETED TO THEIR TOTAL SATISFACTION. UNLESS NOTED BELOW, MATT-CHLOR FROM ANY RESPONSIBILITY FROM ANY OCCIrRBENCE FOL OWING THEIR DEPARTURE FROM THE WORK SITE. SIGNATURI--. PRINTED NAME / DATE