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ARCHIVED REPORTS XR0003352
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 XR0003352
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Entry Properties
Last modified
6/24/2019 11:47:45 AM
Creation date
6/24/2019 10:59:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003352
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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Billing Information CHAIN—OF—CUSTODY RECORD CA Page left <br /> Alpha Analytical, Inc. WarkOrder : STR05090923 <br /> 255 Glendalc Avenue,Suite 21 Sparks,Nevada 89431 5778 <br /> Client TEL (775)355-1044 FAX (775)355-0406 Report Due By 5:00 PM On 19-Sep-05 <br /> Stratus Environmental Scott Bittinaer <br /> TEL (530)676-6009 x <br /> 3330 Cameron Park Drive <br /> Suite 550 FAX (530)676-6005 EDD Required Yes <br /> i <br /> dtinger@stratusinc net <br /> Cameron Park,CA 95682-8861 EMail sbSampled by Justin Crose <br /> Report Attention Scott Bittinger Job USA Gasoline Station No 835 Cooler Temp 40C Date Printed <br /> CC Report PO Client's COC# 06435 09-Sep-05 <br /> QC Level S3 = Final Rpt,MBLK LCS MS/MSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ALCOHOL_ TPwa_s Req w vOest voc w <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS 0 s w <br /> Sample Remarks <br /> STRO5090923-01A CPT-5-10 SO 09/07/05 1 0 6 MroHI BrxFJGASI BTxEcAsl <br /> 1416 aoH soxYs/1 z sa IYS/t 2 <br /> DCA/ DCAIEDB <br /> EDB C <br /> STRO5090923-02A CPT-5-15 I SO 09/07105 1 1 0 1 6 MCOH I f BTXFJGAS/ BTx�eAV <br /> 1423 EtOH I soxYs/1 2 soXYsr 1,2 <br /> DCA/ DCAIEDB <br /> EDH_C <br /> STRO5090923-03A CPT-5-21W I AQ 09/07/05 7 0 6 McOH! GAS: BTEw <br /> 1438 EtOH 5OXY/1 2 <br /> DCA/ <br /> MB-C <br /> STRO5090923-04A CPT-5-28W AQ 1 09/07/05 70 s McOHI GAS C 8TE7t7 <br /> 1455 EtOH 5OXYr 12 <br /> M, <br /> EbB_C <br /> STRO5090923-05A CPT-5-37 I SO 09/07/05 1 0 1 6 McOH I BTXFJGASI BTxFJGASI <br /> 1519 EtOH SOXYS/12 SDXYSI 12 <br /> DCA/ DCN EDB_ <br /> EDB C <br /> STRO5090923-06A CPT-5-45W I AQ 1 09/07/05 7 0 6 McoHI GAS C BTEXI <br /> 1528 E10H soxY1 t 2 <br /> DCA/ <br /> EDa_C <br /> I <br /> Comments SCCUTItY seals intact ice frozen CA sam les Send co of receipt checklist with final report <br /> Signature Print Name Company Date/Time <br /> Received by2 0 1 0— a�p Alpha Analytical,Inc <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples veil 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 1s limited to the amount paid for the report <br /> Matrix Type AQ(Aqueous) AR(Air) SO(Sod) WS(Waste) DW(Dnnking Water) OT(Other) Bottle Type L-Liter V-Voa S-Sad Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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