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ARCHIVED REPORTS XR0006982
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 XR0006982
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Last modified
7/9/2019 3:26:30 PM
Creation date
7/9/2019 2:21:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006982
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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Billing Inform* <br /> CHAIN-OF-CUSTODY RECORD CA Page <br /> 1ofT r <br /> Alpha Analytical, Inc. WorkOrder : STR04090822 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> Client TEL (775)355-1044 FAX (775)355-0406 Report Dere By - 5:00 PM On • 16-Sep-04 <br /> Stratus Environmental Steve Carter <br /> TEL 530 EDD Required Yes <br /> 3330 Cameron Park Drive fi76-6006 <br /> Suite 550 FAX (530)676-6005 <br /> Cameron Park,CA 95682-8861 Job Telchert <br /> Sampled by C Hill <br /> Report Attention Steve Carter PO Client's COC# 07946 Cooler Temp 4°C 08-Sep-04 <br /> CC Report �- <br /> QC Level S3 = Final Rpt,MBLK,LCS, MS/MSD With Surrogates <br /> Requested Tests W <br /> Alpha Client Collection No of Bottles TPIi1P_w voc_w-� - <br /> Sample ID Sample ID Matrix Date ORG 5U8 TAT PWS# __ Sample Remarks <br /> STR04090822-01A MW-13 AQ 09/07/04 5 0 6 BTxE/GAs/ $TXFicAsr <br /> 0934 5oxys/1 2 soxys/1,2 <br /> DCN DCN <br /> EDB C EDB—C <br /> STR04090822-02A MW-14I AQ 09107/04 5 0 fi BTXFJGASr BTXE/GAS/ - -- - <br /> 1013 5oxW 12 5oxys/12 <br /> DCA! DCA/ III <br /> EDB—C EDB—C <br /> STR04090822-03A AS-1 AQ 09/07/04 5 0 fi BTMGAS/ BTXEJGASI <br /> 0953 56xysr 1 2 5oxys/12 <br /> DCN DCA/ <br /> EDB C EDB_C <br /> Comments Security seals intact ice frozen Ca samples Send copy of receipt checklist with final report <br /> Signature _ Print Name _ Company Date/Time <br /> Received by Oa sU"2-� _ � rAlpha Analytical,Inc l <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 /> Matrix Type AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Dnnking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar O-OrbD T-Tedlar B-Brass P-Plastic OT-Other <br />
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