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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0522015
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Last modified
2/6/2019 10:01:00 AM
Creation date
2/6/2019 9:56:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522015
PE
2950
FACILITY_ID
FA0015207
FACILITY_NAME
SJC MOSQUITO & VECTOR CONTROL DIST
STREET_NUMBER
200
Direction
N
STREET_NAME
BECKMAN
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04905031
CURRENT_STATUS
01
SITE_LOCATION
200 N BECKMAN RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Billing Information: E��1%,q ®CHAIN-OF-CUSTODY RECORD CA Page: <br /> 1 0f 1 <br /> APR 2 b i l A Alpha Analytical, Inc. WorkOrder : KLF04041243 <br /> INC5 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> :�r , 'i• TEL:(775)355-1044 FAX:(775)355-0406 Report Due By : 5:001"M On : 16-Apr-04 <br /> Client: KLEINFEL <br /> Kleinfelder y Doug Heard <br /> 2825 East Myrtle Street TEL: (209)948-1345 EDD Required: No <br /> FAX: (209)948-0621 <br /> Stockton,CA 95205 Job: 42747.TO1-SJC/MVCD Sampled by:Client/6238 <br /> Report Attention: Doug Heard PO: Client's COC#: 2840 Cooler Temp: 4°C 12-Apr-04 <br /> CC Report: <br /> QC Level: 3 = Final Rpt,MBLK, LCS, MS/MSD <br /> Requested Tests <br /> Alpha Client Collection No.of Bottles TPHIE 5 <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# Sample Remarks <br /> KLF04041243-01A 29087-Ct SO 04/07/04 1 0 4 trHre_c <br /> 12:25 <br /> KLF04041243-02A 29088-C2 SO 04/07/04 1 0 4 T?w c <br /> 12:32 <br /> KLF04041243-03A 29089-C3 -SO 04/07/04 1 0 4 TPS c <br /> 12:40 <br /> KCF64041243-64AI 29090-C4 SO 04/0704 1 0 4 TrtvE_c <br /> 29091-05 SO 04/07/04 j 1 0 4 -------- - _--� - - - - - - --- --- — <br /> KLF04041243-OSA TPt�_c <br /> 1257 <br /> _ _-- <br /> 1303 <br /> KLF04041243-06Ai -29082-C6 SO 04/07/04 �0— 4 TPHIE C. <br /> • <br /> Comments: Custody seal Frozen ice Samples received 4/10/04,samples kept cold&secure until loe-in 4/12/04.: <br /> � <br /> "Signature i Print Name / Company Date/Pime <br /> � <br /> Received by: C/f�`"' ? �` Alpha Analytical,Inc. L(I tg'1 Dq ISS <br /> NOTE: Samples are discarded 60 days after results are reported unless other arrangements are made. Hazardous samples will be returned to client or disposed of at client expense. <br /> The report for the analysis of the above samples is applicable only to those samples received by the laboratory with this COC.The liability of the laboratory is limited to the amount paid for the report. <br /> Matrix Type: AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type: L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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