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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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88 (STATE ROUTE 88)
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13975
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2900 - Site Mitigation Program
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PR0522057
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Last modified
11/20/2024 9:23:26 AM
Creation date
9/5/2019 2:14:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522057
PE
2950
FACILITY_ID
FA0015024
FACILITY_NAME
USA GASOLINE #3756
STREET_NUMBER
13975
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
APN
01908014
CURRENT_STATUS
01
SITE_LOCATION
13975 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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• v A • <br /> Alpha Analytical, Inc. <br /> Phone : (775)355-1044 FAX: (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 10/31/2006 Date of Notice: 10/23/2006 12:45:10 <br /> Please take note of any NO check marks.If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested. <br /> Client Name: Stratus Environmental Project ID : 2007-3756-1/USA Station No. 3756 <br /> Project Manager: Scott Bittinger Client's EMail: sbittinger@stratusinc.net <br /> Client's Phone: (530)676-2062 Client's FAX: (530)676-6005 <br /> Work Order Number: STR06102306 Date Received: 10/21/2006 Received by:Elizabeth Sauvageau <br /> Chain of Custody(COC)Information <br /> Carrier name: FedEx <br /> Chain of custody present? Yes 0 ❑ No <br /> Custody seals intact on shippping container/cooler? Yes 0 ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present 0 <br /> Chain of custody signed when relinquished and received? Yes V ❑ No <br /> Chain of custody agrees with sample labels? Yes W ❑ No <br /> Sample ID noted by Client on COC? Yes W ❑ No <br /> Date and time of collection noted by Client on COC? Yes W ❑ No <br /> Samplers's name noted on COC? Yes 0 ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ ❑ No <br /> Sub Contract Lab Used : None W ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes 0 ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes W ❑ No <br /> Sample containers intact? Yes 0 ❑ No <br /> Sufficient sample volume for indicated test? Yes 0 ❑ No <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes No 4.c <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ ❑ No No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes V ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A ❑�/ <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ W No <br /> Are there client specific Project requirements? Yes El No If YES :see the Chain of Custody(COC) <br /> Comments : <br />
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