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ARCHIVED REPORTS XR0006979
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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103
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3500 - Local Oversight Program
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PR0544638
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ARCHIVED REPORTS XR0006979
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Entry Properties
Last modified
7/9/2019 3:22:15 PM
Creation date
7/9/2019 2:20:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006979
RECORD_ID
PR0544638
PE
3528
FACILITY_ID
FA0004027
FACILITY_NAME
HENDRIX FORK LIFT INC
STREET_NUMBER
103
Direction
N
STREET_NAME
E
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15318001
CURRENT_STATUS
02
SITE_LOCATION
103 N E ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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i • i <br /> Billing Information CHAIN-OF-CUSTODY RECORD CA Page f of f ` <br /> Alpha Analytical, Inc. WorkOrder : STR05053130 <br /> 255 Glendale Avenue Suite 21 Sparks,Nevada 89431 5778 <br /> TEL (775)355-1044 FAX (775)355-0406 _ _ Report Due By .: S 00 PM On 08-Jun-05 <br /> Client. Steve Carter <br /> Stratus Environmental TEL (530)676-6008 x <br /> 3330 Cameron Park Drive FAX (530)676-6005 EDD Required Yes <br /> Suite 550 EMall scarter@stratuslnc net <br /> Cameron Park CA 95682-8861 -- Sampled by C Hil <br /> Report Attention Steve Carter Job 2001 01031 Teschert Cooler Temp 40C Date Printed <br /> CC Report PO Client's COC# 05577 31-May-05 <br /> QC Level S3 = Final Rpt,MBLK LCS MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles TPIUP_w voc_w <br /> I <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# _ Sample Remarks <br /> STRO5053130-01AI MW-13 AQ 05/27/05 5 0 6 BTxEIGASr BTXEIGASr 1 <br /> 0630 5axy-1 t 2 5oxysi 1.2 I <br /> DCA/ DCA/ <br /> EDB_C EDS C <br /> STR05053130 02A MW-14 , Q 05/27/05 5 0 6 BTXF16AS BTXEIGASI - <br /> 06 20 so:y5+12 soXy�1 2 <br /> DCA DCA/ <br /> EDD-C EDB C <br /> STR05053130-03A AS-1 AQ 05127/05 5 0 6 BTxEJG" BTXE/GASr, <br /> 0641 5oxys/12 Soxys/1 2 I <br /> DCA! DCA/ <br /> EDB-C EDB-C--- <br /> Comments <br /> DBCComments Sceurgy seals intact Saturday shipment,samples kept(@,4 C in secured area until logged in on Tuesday,due to Holiday_Ca samples Send copy of receipt checklist with final report <br /> Signature __ Print Name Company Daterrime <br /> Received by l _ �f Alpha Analytical,Inc <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 /> MatnxType AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Dnnking 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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