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ARCHIVED REPORTS_XR0002623
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_XR0002623
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Entry Properties
Last modified
2/3/2020 7:01:16 PM
Creation date
2/3/2020 11:21:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002623
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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Billing lnformati4b CHAIN-OF-GUST D1G� � • <br /> O n��COinW CA <br /> Page <br /> 3of8 <br /> Alpha Analytical, Inc. WorkOrder : STR04051845 <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 : 26-May-04 <br /> Stratus Environmental Scott Bittrnger <br /> 3330 Cameron Park Drive TEL (530)676-6009 <br /> Suite 550 FAX (530)676-6005 EDD Required Yes <br /> Cameron Park CA 95682-8861 Job 2033-15600-011Joes Truck Plaza Sampled by Evan/Scott <br /> Report Attention Scott Blttinger PO 2033-15600-1 Client's COC# 314813149131501315113153 Cooler Temp 4 oC <br /> CC Report 18-May-04 <br /> QC Level S3 = Final Rpt,MBLK,LCS,MS/MSD With Surrogates <br />' Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL L _ALCOHOL TPHIE_S TPHIE_W TPHIP_S TPH/P_W voC_s vOC_W <br /> Sample ID Sample ID Matrix Date t7RG SUB TAT PWS# <br /> Sample Remarks <br /> STR04051845-19A' CPT6-21 —' SO 05/13/04 j 1 0 6 Low Level TPH1E_C BTXEIGAS i BTXEIGAS W ---��-- <br /> 1215 MeoHIEIOH <br /> ClSaxys/i 26I 05oxysll 2D I <br /> CAIEDB CAIEDB <br /> STR04051845-20AI CPT6-32 AQ 05/13/04 4 0 6 1 Law Lcvcl , TPHIE c +BTxEIGAs BTXEJGAS_ One nonpreserved He two <br /> 1220 McOWBOH v <br /> I cnxo20 cKxom <br /> CAIEDB CAIEDEDB preserved reserved VOA's rcv'd <br /> STRO4051845-21AI CPT649 ' SO 05113/04 1 0 ' 6 � Low Levelbroken <br /> TPHIE C BTXEIGAS + BTXEIGAS <br /> 1240 McOHIEtOH C15oxysll 2D1 C15oxys+l 26 <br /> CAIEDB CAIEDB <br /> STR04051845-22Al CPT6-63 AQ 05/13/04 7 0 6 Loa Leve] rnHIE_c BTxEIGAs_ HTwGAs_� <br /> 12 50 McOHEtOH 'C15xoys!12D Cl4xoysll2D <br /> STR04051845-23A CPT7-8 SO 05!13!04 1 0 6 Low Level CAIEDB CAIEDB <br /> i TPHIE_C BTXElGAS BT3.EfGAS_ <br /> 14 25 McOHlEtOH ClSoxysll 26' C,50xyvl 20 <br /> STR04051845-24A CPT7-12 AQ 05/13/04 7 0 ; 6 Low Level i TPHIE_C CAIEDB CAIEDB BTKE/GAS BTXFJGAS <br /> 1430 McOH/EiOH IC15xoysll 26 Clsxoysll 26' <br /> CAIEDB CAIEDB <br /> 84 <br /> STR040515-25A1 �CPT7-21 '' SO 05/13/04 1 0 i 6 Low Leel TPHlE_C � BTxEIGAs E BTxEIGAs _ <br /> 14 35 McOW1EtDH 1 C150xysll 2Di ClSoxyVl 2D <br /> CAIEDB CAIEDB <br /> STR04051845-26A'—CPT7-39 AQ 05/13/04 7 0 6 Loa Le%d TPH/E_C 1BTxEIGAs BTxCrJGAS <br /> 1445 McOHIEIOH C15xoys/l 2D C11xoys1l 2DI <br /> STRO4051845-27AI CPT749 SO 05/13/04 1 0 6 Lon Level TPWE CAIEDB C BTXEIGAS_' BTXE/GASCAIED9 <br /> _ <br /> 15 10 McOHIDOH C15oxys/t 2DI C15o%ysl1 2D k <br /> --`"—T�--- ---- ------ _�� CAIEDB CAIEDB <br /> Comments Custody seal Frozen Ice Send c0PV of recel t checklist with final re ort Some VOA's received broken sce Remarks on COC <br /> Signature Print Name Company P y Date/Time <br /> Received by <br /> ! Alpha Analytical,tnc r* � <br /> i <br /> MOTE 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 analysts 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(S010 WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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