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ARCHIVED REPORTS_XR0002622
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_XR0002622
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Last modified
2/3/2020 6:15:06 PM
Creation date
2/3/2020 11:21:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002622
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)3554)406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 6/25/2004 Date of Notice 6/17/2004 11 55 13 <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 2033-15600-01/Joe's Truck Plaza <br /> Project Manager Gown Kowtha Client's Phone (530)676-0002 Client's FAX (530)676-6005 <br /> Work Order Number STRO4061704 Date Deceived 6/17/2004 Received by Laura Long <br /> Chain of Custody(COQ Information <br /> Carrier name FedEx <br /> Chain of custody present 7 Yes © ❑ No <br /> Custody seals intact on shippping container/cooler 7 Yes © ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles ? Yes ❑ ❑ No Not Present ❑� <br /> Chain of custody signed when relinquished and received? Yes © ❑ No <br /> Chain of custody agrees vAth sample labels? Yes © ❑ No <br /> Sample ID noted by Client on COC? Yes © ❑ No <br /> Date and time of collection noted by Client on COC? Yes © ❑ No <br /> Samplers's name noted on COC 0) Yes © ❑ No <br /> Internal Chain of Custody(COC) requested v Yes ❑ © No <br /> Sub Contract Lab Used None © ❑ SEM Other(see comments) ❑ <br /> Sample Recer t Information <br /> Shipping container/cooler in good condition'? Yes © ❑ No Not Present ❑ <br /> Samples in proper containerlbottle? Yes © ❑ No <br /> Sample containers intact'? Yes © ❑ No <br /> Sufficient sample volume for indicated tests Yes © ❑ No <br /> Sample Preservation and Hold Time H 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 © ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A <br /> Analytical Re uirement 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(GOC) <br /> Comments <br />
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