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ARCHIVED REPORTS_XR0002621
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_XR0002621
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Entry Properties
Last modified
2/3/2020 6:33:11 PM
Creation date
2/3/2020 11:20:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002621
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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Alpha Analytical, Inc. <br /> . Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 9/2712004 Date of Notice 9/1712004 11 17 31 <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 Joes Truck Plaza <br /> Project Manager Steve Carter Client's Phone (530)676-6008 Client's FAX (530)676-6005 <br /> Work Order Number STR04091744 Date Received 911712004 Received by Dolly S Baker <br /> Chain of Custody COC Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes ❑ No <br /> Custody seals intact on shippping contain erlcooler? Yes 0 ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present ❑� <br /> Chain of custody signed when relinquished and received? Yes 0 ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Sample ID noted by Client on COC? Yes 0 ❑ No <br /> Date and time of collection noted by Client on COC? Yes No <br /> Samplers's name noted on COC? Yes No <br /> 0nternal Chain of Custody(COC)requested? Yes ❑ No <br /> Sub Contract Lab Used None SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes ❑ ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ No <br /> Sample containers intact? Yes FV ❑ No <br /> Sufficient sample volume for indicated test? Yes W ❑ No <br /> Sample Preservation and Hold Time HT Information <br /> All samples received within holding time? Yes ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes ❑ No 4'C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA ❑� <br /> Anal ical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ 0 No If YES see the Chain of Custody(COC) <br /> Comments Sample time not listed on COC,sampling time taken from sample VOA's <br />
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