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ARCHIVED REPORTS_XR0002621
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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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Billing Inform CHAIN-OF-CUST011Y RE 10page <br /> CORD CA <br /> 2of2 <br /> Alpha Analytical, Inc. Workorder : STR04091744 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> Client. TEL (775)355-1044 FAX (775)355-0406 Report Due By - 5.00 PM On : 27-Sep-04 <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 Plaza Sampled by C Hill <br /> Report Attention Steve Carter PO Client's COG# 08378 Cooler Temp 4°C 17-Sep-04 <br /> CC Report <br /> QC Level S3 = Final Rpt MBLK,LCS,MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ <br /> _ TPHIE_W TPHIP_W vac w <br /> Sample ID Sample ID Matrix Date QRG SUB TAT PWS# Sample Remarks <br /> STR04091744-10A' MWO-2 AQ 09/16/04 I 8 0 6 McOWDOH TPHIE_C 13TXEIGAS BTXElGA4 — -0739 CrB 11 2DCA Cl11 2DCA B <br /> STR04091744-11A1 MWO-3 AQ 09/16/04 8 o I 6 WOHIROH TPWE C BTXE/GAS_ BTXE/GAS <br /> 0758 I ClSorys/EDB C/Soxys/EDB <br /> 11 2DCA 11 2DCA <br /> Comments Custody seal Frozen ice Send.copy of receipt checklist with final report Sample time not listed on COC sampling time taken from sample VOA's <br /> Signature at Print Name Company I DatelTlme <br /> Received by Alpha i�Q� V jf�]C�- [C r' Alpha Analytical,Inc Q f 1 v:)� <br /> NOSE 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-Sod Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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