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ARCHIVED REPORTS_XR0002624
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_XR0002624
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Entry Properties
Last modified
2/3/2020 6:25:31 PM
Creation date
2/3/2020 11:22:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002624
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 Informa� <br /> CHAIN-OF-GUSTO* RECORD �a e t. <br /> 2 0l 2 <br /> CA g <br /> Alpha Analytical, Inc. <br /> 255 Glendale Avenue,sate 21 Sparks,Nevada 89431-5778 WorkOrder ., <br /> STR04070248 <br /> Client TEL (775)355-1044 FAX (775)355-0406 Report Due By : 5;00 PM On ; 13-Jul-04 <br /> Environmental Gowr_` KOwlha <br /> 3330 Cameron Park Drive Steve Carter <br /> TEL (530)676-6002 TEL (530)676-6008 <br /> Suite 550 FAX (530}676-6005 FAX (530)676-6005 EDD Required yes <br /> Cameron Park,CA 95682-8861 Job Joes Truck Stop <br /> Report Attention Gown KowthaPO Sampled by Mike CC Report Steve Carter Client's COC# 07385 Cooler Temp 4 oC <br /> 02-Jul-04 <br /> QC Level S3 W Final Rpt,MBLK LCS,MS/MSD With Surrogates <br /> Requested Tests <br /> Alpha Client <br /> Collection No of Bottles ALCOHOL— TPHIE w TPH1P W voc w <br /> Sample ID Sample ID Matrix Date QRG SUB TAT PWS# w - - - <br /> STR04070248 10A Sample Remarks <br /> MWQ-3� AQ 06/29/04 8 0 6 McVMMGH TPHIE_C BTXEIGAS RTX Sample <br /> — <br /> 0928 E Cl5oxysli 2D Cl5oxys/i 2D -— <br /> CA/EDn CA/EDB T` <br /> Comments Custody seal Frozen ice EDF Send copy of rete] t checklist with final report ne non reserved VOA for MW-2 received broken <br /> Signature � <br /> Received by � Print Name Company Date/Time <br /> (Jy} <br /> �D b" e-cjr Alpha Analytical,Inc /a lbC4 (� <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(SOd) WS(Waste) OW(Drtnkmg Water) OT(Other <br /> ) Bottle Type L Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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