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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
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EHD - Public
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Billing Informal* CHAIN-OF-CUSTOM RECORD <br /> age <br /> CA 4of6 <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 Bittlnoer <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-OIIJoes Truck Plaza Sampled by Evan/Scott <br /> Report Attention Scott Blttinger PO 2033-15600-1 Client's COC# 314813149131501315113153 <br /> CC Report Cooler Temp 4°C 1$-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 ALCOHOL_ TPHIE 5 TME-W TPHIP 5 TPHIP W vOC S VOC W <br /> Sample ID Sample ID Matrix Date ORG SERB TAT PWS# s W - - - <br /> STR04051845 28A` CPT7-64 TPHSample Remarks <br /> AQ 05113/04 i 7 0 6 Lowl.,e�el IE_C 'BTXEJGAS_ HIXEJGAS 1 <br /> 1,525 MeowEtOH CJSxoyjl 2D Clixoysll 25' <br /> STRO4051845-29AI CPT7-80 AQ 05/13/04 7 0 6 Lou Leel <br /> CAIEDB CAIEDB <br /> TPH/E_C BTXFJGAS <br /> 15 50 i McOH/EtoH `C 5xoys/12D 0Kxoys/1 261 <br /> 5TR04Q51845-30A CPT3 8 ! SO 05/14/04 i Q 6 Low Level CAIEDB CAIEDB <br /> OT 2O Me0H1EtOH TME BTXE/GAS ; BTXEIGAS <br /> _ ____ C15ory81125, C15vxys/l26 1 <br /> STR04051845-31A' CPT3-12 AQ 05/14/04 7 0 6 Law Leel TPHIE C CAIEDB cAlEDB_ <br /> BTXEIGAS BTXEIGAS <br /> 0730 Meoll/EtOI-I - rC/Sxoys/I 20 <br /> ---- C/Sxoysll 25 <br /> STR04051845-32AI CPT3-15 SO 05/14/04 1 0 6 Low Level TPHIE C CAIEDB cwleD6 <br /> BTXEfGAS <br /> 0740 McOHIDOH C15oxys/l 2DC� 5oxEysll 2D f <br /> 5TR04051845 33A)�CPT3 18 AQ 0511410 7 0 6 T- Low Leel — — CAIEDB CAIEDB Y <br /> WIVE BTXFJGAS_ HTXFIGAS <br /> 0750 ' I MeoHrEtOH 1ClSxvys/l 2D ClSxvys/i 251 <br /> STR04051$45-34A CPT3-23 SO 05/14104 1 0 6 Low Leel TPHIE C BTXE/GAS CAIEDB CAIEDB ' <br /> 0800 WOHIDOH - � BTXE/GAS <br /> _ ClSoxys112D C/3oxys/l25 j <br /> STR04051845-35Ai CPT3-30 AQ 05/14/04 j 6 0 1 6 Low Lei CAIEDB CA/EDB <br /> 08 10 McOHlEte TP14/E_C BTXE/GAS_ BTXEIGAs 1 One nonpreserved VOA <br /> IC/5xoyv1 213 C15rnysll 21)1 rCV'd broken <br /> STR04051845-36AI CPT3-48 SO 05/14/04 ; 1 0 6 Low Leve] CAIEDB CAIEDB <br /> TPHIE C BTXE/GAS <br /> 0830 WOHID014 C5vxys1l 25 CSoxysll 26 <br /> CAIEDB CAIEDB <br /> Comments Custody seat Frozen ice Send copy of recril3t checklist with final report Some VOA's received broken see Remarks on COC <br /> Recened by anv <br /> Signature Print Name Com <br /> P UatelTime <br /> D�� <br /> 40 -�D qA5-6-Lejy Alpha Analytical,Inc Sd6 fg's�;— <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 AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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