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ARCHIVED REPORTS_XR0002622
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_XR0002622
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Entry Properties
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
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SJGOV\sballwahn
Tags
EHD - Public
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• • • <br /> Billing Information CHAIN-OF-CUSTODY RECORD �A Page e <br /> 10f1 <br /> Alpha Analytical, Inc. WorkOrder : STR04061704 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> TEL (775)355-1044 FAX (775)355-0406 Report Due By : 5:001"M On : 25-Jun-04 <br /> Client -- — -- <br /> Stratus Environmental Gown Kowtha <br /> 3330 Cameron Park Drive TEL (530)676-6002 EDD Required Yes <br /> Suite 550 FAX (530)676-6005 <br /> Cameron Park,CA 95682-8861 Job 2033-15600-Ol/Joe's Truck Plaza Sampled by MW Morgan <br /> Report Attention Gown Kowtha PO Client's COC# 07992 Cooler Temp 4°C 17-Jun-04 <br /> CC Report <br /> OC Level S3 = Final Rpt,MBLK,LCS,MS/MSD With Surrogates <br /> _ ---- - - -- -- - - — ------ —------- ----- Requested Tests - --- -- <br /> Alpha Client Collection No of Bottles TPNH w voc w --- - - <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# _1 _ — - -- Sample Remarks <br /> STR04061704-01 MW-7 -----�AG I Ofi116a004 ��-0 I-�� °�s� eTSCF�M� �T - -___ 1---- - - —} <br /> Comments Frozen ice Security seals Send copy of checklist with final report <br /> Signature Pnnt Name Company Date/Time <br /> Au� <br /> Received by , buLQL l M3 Alpha Analytical,Inc 07104 &(5 <br /> J <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 AO(Aqueous) AR(Air) SO(Sod) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S Sad Jar O-Orbo T-Tedlar B Brass P Plastic OT-Other <br />
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