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ARCHIVED REPORTS XR0003353
EnvironmentalHealth
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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 XR0003353
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Entry Properties
Last modified
6/24/2019 11:46:03 AM
Creation date
6/24/2019 11:01:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003353
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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• ASENDED • - <br /> Billing Information CHAIN-OF-CUSTODY RECORDCA Page 10f2 <br /> r <br /> Alpha Analytical, Inc. WorkOrder : STR05092906 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> TEL(775)355-1044 FAX (775)355-0406 Report Due By : 5:00 PM On : 06-Oct-05 <br /> Client Gown Kowtha <br /> Stratus Environmental TEL (530)676-Ml <br /> 3330 Cameron Park Drive FAX (530)676-6005 EDD Required Yes <br /> Suite 550 EMail gkowtha@straltzric net <br /> — Sampled by M MorganlV Zalutka <br /> Cameron Park,CA 95682-8861 <br /> Report Attention Gown Kowtha Job 2007-0835-01AJSA 835 Cooler Temp 4 OC Date Panned <br /> CC Report PO Client's COC# 6832 18-Oct-05 <br /> QC Level S3 = Final Rpt,MBLK,LCS,MS/MSD With Surrogates <br /> Requested Teats <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPKX_w T7L7 <br /> w <br /> Sample ID Sample 1D Matrix Date ORG SUB TAT PWS Sample Remarks <br /> STRO5092906-01A MW-1 AQ I 09/28/05 8 0 5 W011/ I T wE_c r s.0 sTEXroxYr <br /> 0937 1 1 Pi011 t 2DCA C <br /> STRO5092906-02A MW-2 AQ 09/28/05 8 0 5 McOHr I TPHrEc GAS-C ter 1 zDcA_CA-c <br /> Yr <br /> 0912 DO" <br /> STRO5092906-0 MW-3 AQ 09/28/05 8 0 5 McGH! I TPHrEc I GAS erEWXYI <br /> 1007 Elon 1 2DCA_C <br /> STRO5092906-04 MW-4 AQ I 09/28/05 8 1 0 1 5 1 McCulI TPHrE C GAS-C aTP.WXW <br /> 1139 EtOH 1,2DCA C <br /> STRO5092906-05A MW-5 AQ 1 09/28/058 0 5 McoHr TPHIE_C cAsc stF"XYr <br /> 11 11 EtoH 1,2DCA C <br /> STRO509 MW-6 AQ 09/28/05 8 05 McOHr TPIVE C GAS-C SrEX,0XYr <br /> 1041 EtOH 1 2DCA`C <br /> STRO50929WO7 MW-7 AQ 09/28/05 8 0 5 WON/ TPwE C GAS C Irr&wxrr <br /> 0857 RON 12DCA_C <br /> 5TR05092906 08A MW-8 �l x09128/05 6 0 5 MdIH! I TPIirE_C GAS C BTE?tJ(]XYr <br /> I I 11 Q5 �� D011 1 2DCA_C T — ---- 1 <br /> STRO5092906-09A MW-9 AQ 09/28/05 B 0 5 m OHI T"Im r- GAS-C MIAMY1 <br /> 11 45 I moo]i t 2DCA_c <br /> � AQ T09128I05 8 5 <br /> �TRO5092906-101 MW-10 � �Ma1Hr TPWE c� GAS-C trrrauo C T <br /> 1025 `1011 I 1 zocA c -- <br /> Comments Secunty seals intact,frozen ice Send copy of receipt checklist with final report Amended 10-18-05 to change ID on sample 12.per Tammy@SEC via Rema SS <br /> I Signature -�` �� -- -- Print Nariie� - - -- Company -- Datt/Time <br /> Logged in by. Com] - - - - — - - - --- ----- -S � ",t�-tel C��� Alpha Analytical,Inc— <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be retumed 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 limned to the amount paid for the report <br /> Matnx Type AQ(Aqueous) AR(Alr) SO(Soil) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar &Brass P-Plastic OT Other <br />
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