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ARCHIVED REPORTS XR0003351
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2705
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3500 - Local Oversight Program
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PR0544595
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ARCHIVED REPORTS XR0003351
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Entry Properties
Last modified
6/24/2019 1:09:28 PM
Creation date
6/24/2019 10:59:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003351
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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r <br /> Billing Information CHAIN-OF-CUSTODY RECORD CA Page 1 oft ; <br /> Alpha Analytical Inc. <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431 5776 WorkOrder : STR45122325 <br /> TEL (775)355-1044 FAX (775)355-0406 _ Report Due By : 5'00 PM On ' 04-Jan-06 <br /> Clittnt Gown Kowtha <br /> Stratus Environmental TEL (530)676-6001 x <br /> Suit Cameron Park Dnve I <br /> FAX (530)676-6005 EDD Required Yes <br /> Suite 550 EMad gkowtha@stratusinc net <br /> Cameron Park,CA 95682-8861 — Sampled by Vince Zalutka <br /> Report Attention Gown Kowtha ,lob 2007-0835-011 USA 835 Cooler Temp 4 OC Date Punted <br /> CC Report PO Client's COC# none 23-Dec-05 <br /> QC Level S3 = Final Rpt MBLK LCS,MSIMSD With Surrogates <br /> T T Requested Tests <br /> Alpha Client Collection No of BottlesALCOHOL_ TPHIE w TPHIP_w vac w ' <br /> w <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# I I Sample Remarks <br /> S OTR 5122325-01A MW 1 �AQ 12/22/05 8 0 1 6 WOHr TPIVE_C GAS-CeTEX/ <br /> 0745 1 i EtOH soxyl 1 2 1 <br /> DCA-C <br /> STRO5122325-02AI MW-2 i AQ 12/22/05 8 0 1 6 M.OHI TPRE_C I GAS.0 BrEx, I <br /> 1021 i EtOH I I Soxw 12 ' <br /> _ DCA-C ` <br /> STR05122325-03A MW-3 AQ 12122!05 8 0 16 McOH! I TPHE_c cAS-CA RTF)Q , <br /> 1 t)8 17 EtOH I 5OXY/1,2 <br /> DCA C <br /> STRO5122325-04A MW-4 AQ 12/22/05 8 0 i 6 McoHl TPHE-C , oAs-C BTEw <br /> 09 34 I E10H I 5Oxvr 1,2 <br /> _ _ DCA-C <br /> STRO5122325-0SA MW-5 AQ 12!22!05 �8 0 6 MCOHr TPHrE_C i GAS C BTEX! - <br /> 0911 i Enol{ 5oxyr 12 1 I I <br /> OCA C <br /> STR05122326-06AI MW-6 AQ 12122/05 8 0 6 McOHr TPM_C i cAs-c eTEX! I I I <br /> i <br /> 0841 i WH I soxyr 1.2- <br /> - <br /> a- I <br /> DCA C <br /> STR05122325-07Ai MW-7 AQ 12122/05 8 0 ' 6 McOH! I TPwE C GAS C EffUd <br /> I <br /> 0804 EtOH _ I 50XY1 1,2 i <br /> DCA C <br /> STR05122325-08A MW-8 AQ 12/22/05 8 0 6 MAH! TPFUE_C i GAS-C- BTEx� - ---- <br /> 9917 ��-- - -- EtOH 50XV 1 2 l <br /> --- --- - - -- --- ------- DCA-C <br /> Comments Securily seals intact.ice frozen Ca samples Send cM of receipt checklist with final repart For last two sampics on coc ID's on coc versus chain do not match Logged in as pg voa Id's.as Dm <br /> ical sa le ID's on other work orders <br /> ��jj Signature _ _ Print Name Company Dfte/l'imey-� <br /> Logged in by Q Get!=! -- - �_ — — ja�-C re- -Alpha Analytical,Inc IG rGy - —�✓ <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 GOC The lability of the laboratory is limited to the amount paid for the report. <br /> Matrix Type AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Dnnking Water) OT(Other) Bottle Type L-Liter V-Voa S-Sod Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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