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ARCHIVED REPORTS_XR0002601
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HARLAN
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15600
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3500 - Local Oversight Program
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PR0545273
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ARCHIVED REPORTS_XR0002601
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Entry Properties
Last modified
2/3/2020 6:38:10 PM
Creation date
2/3/2020 11:11:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002601
RECORD_ID
PR0545273
PE
3528
FACILITY_ID
FA0000174
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15600
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620079
CURRENT_STATUS
02
SITE_LOCATION
15600 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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C <br /> Billing InformatlorO - <br /> CHAIN-OF-CUSTODY RECORDPage <br /> CA 1 oft <br /> Alpha Analytical, Inc. WorkOrder : STR03122243 <br /> 255 Glendale Avenue Suite 21 Sparks,Nevada 89431-5778 <br /> Client TEL (775)355-1044 FAX (775)355-0406 Report Dile By : 5:00 PM On : 31-Dec-03 <br /> Stratus Environmental Steve Carter <br /> 3330 Cameron Park Drive TEL (530)676-6008 EDD Required Yes <br /> Suite 550 FAX (530)676-6005 <br /> Cameron Park CA 95682-8861 Job Joes Truck Stop Sampled by Mike <br /> Report Attention Steve Carter PO Client's COC# 3468 Cooler Temp 4 OC 22-Dec-03 <br /> CC Report <br /> QC Level S3 = Final Rpt MSLK LCS,MS/MSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPHIE_W TPHIP_w voC w ; <br /> W <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# Sample Remarks <br /> STR03122243-OIA' MW-1 AQ 12/19/03 ! 8 0 6 MCOH/EIOH TPHIE_C 13TXEJGAS_ BTxF)GAs <br /> 0905 C15oxys1ED6 C/Soxys/EDB <br /> /12DCA /12DCA <br /> STR03122243-02A MW-2 AQ 12/19/03 8 0 6 McOWEIOH TPHIE_C BTXEIGAS_IBTXFYGAS <br /> 08 24 C/Saxys/EDBfC5oxyslMfi <br /> 112DCA 112DCA <br /> STR03122243-03A MW-3 AQ 12/19/03 8 0 6 WOWDOH TPHIE_C BTXE/GAS 13TXEIGAs_ - <br /> 05 38 C/SaxysIEDB C15oxys/EDB <br /> _ 712DCA /I 2DCA <br /> STR03122243-04A MW-4 X-6- 12/19/03 I 8 0 6 McoH/EtOH TPH/E_C BTXEIGAS BTXrJGAs <br /> 0447 a5oxy-JEDB C/5oxys/EDB <br /> 112DCA 112DCA <br /> STR03122243-05A, MW-5 AQ 12/19/03 7 0 6 McOHIEIOH TPH/E C BTXE/GAs BTXEJGAS_ <br /> 0755 E 05oxys/H013 C/5oxys/EDB <br /> 11 2DCA /1 2DCA <br /> STR03122243-06A_ MW-6 AQ 12/19/03 1 8 0 6 McOHIE10H TPHIE_C BTXFGAS BTXEIGAS - <br /> 05 10 C/5oxysIEDB�C/5oxWEDB <br /> /1 2DCA /1 2DCA <br /> STR03122243-07A MWO-1X AQ 12/19/03 E 8 0 6 McOH/EtOH TPHIE C BTXEIGAS_ BTXEIGAS_ - <br /> 08 44 05oxys/ED8 C15oxys/EDB <br /> 112DCA /12DCA <br /> STR03122243-08A, MWO-1 AQ 12/19/03 1 8 0 6 McOH/DOH TPHIE_C BTXEIGAS IBTXVGAS — --- <br /> 0959 1 C15oxys/EDB1C15oxys1ED5 <br /> 11 2DCA It 2DCA <br /> STR03122243-09A MWO 2 AQ 12/19/03 8 0 6 WOHICIOH TPHIE_c BTxE1GAs_ BTxEIGAS_ <br /> 0947 C/5oxys/EDB C15oxys/EDB <br /> /I 2DCA 112DCA <br /> Comments Custody sea[ Frozen ice CA samples Samples received Saturday 12/20/03 samples kept cold&secure until log in Monday 12/22/03 EDF Send copy of receipt checklist with Final report One <br /> VOA for MW-5 received broken <br /> Signature Print Name p Company Daterrime <br /> Received by �j; b L _ 9} X1-f�1�f4 Alpha Analytteal,Inc <br /> 1 <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(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plaslic OT-Other <br />
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