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ARCHIVED REPORTS XR0003350
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0544595
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ARCHIVED REPORTS XR0003350
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Last modified
6/24/2019 11:38:23 AM
Creation date
6/24/2019 10:55:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003350
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Alpha Analytical, Inc. <br /> • Phone (775)355-9044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 4/3/2006 Date of Notice 3/27/2006 9 23 05 A <br /> Please take note of any NO check marks If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Protect ID 2007-0835-011USA 835 <br /> Clients EMail gkowtha@stratusinc net <br /> Protect Manager Gown lCowtha Client's Phone (530) 676-6001 Clients FAX (530) 676-6005 <br /> Work Order Number STR06032745 Date Received 3/24/2006 Received by Lairicia Edrosa <br /> Chain_of Custody(COC) Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes No <br /> Custody seals intact on shippping container/cooler? Yes No Not Present ❑ <br /> Custody seals intact on sample bottles ? Yes ❑ ❑ No Not Present ❑�/ <br /> Chain of custody signed when relinquished and received ? Yes ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Sample ID noted by Client on COC? Yes ❑L/ ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br /> Samplers's name noted on COC? Yes ❑ No <br /> 4 rnal Chain of Custody(COC)requested? Yes EJ WNo <br /> 11' Contract Lab Used None ❑,r ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in goad condition? Yes ❑d ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes 2 ❑ No <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes 0 ❑ No <br /> Sample Preservation and Hold Time_IHT) Information <br /> All samples received within holding time? Yes 0 ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance (0-6'C)? Yes W ❑ No 4°C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes k ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA 0 <br /> AnaMical Requirement information <br /> Are non-Standard or Modified methods requested ? Yes ❑ R] No <br /> Are there client specific Project requirements ? Yes ❑ D No If YES see the Chain of Custody(COC) <br /> Comments Samples received Fn (3124)but not logged in until Mon(3127) Samples kept cold and secure until login Various voas rec d broken- <br /> all samples have sufficient volume left for all analysis VQA's for VEW-1 rec d labeled VW-1 &VOA S for VEW-3 recd labeled VW-3 <br /> Logged both samples in as per chain <br />
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