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3500 - Local Oversight Program
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PR0545420
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/5/2020 5:33:06 PM
Creation date
3/5/2020 4:20:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545420
PE
3528
FACILITY_ID
FA0003815
FACILITY_NAME
TESORO (SPEEDWAY) 68154
STREET_NUMBER
2500
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
02740006
CURRENT_STATUS
02
SITE_LOCATION
2500 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Billing Information-,: ,� Alpha Analytical, Inc. J <br /> Name +a�� �� 255 Glendale Avenue,Suite 21 Page ft Sparks.Nevada 89431-5778 —_.1 of <br /> City,State,Zip Phone (775)355-1044 <br /> Phone Number Fax Fax (775)355-w6 Analyses Required <br /> Client Nama P.O.# Job# <br /> w f G©or �g�, Ll <br /> Address Q f G PWS# DWRa <br /> S <br /> City,Stats Zip � C7 Phone# Fax <br /> per' Office Use samp€edby � ReportAbntion x <br /> Time bate $eeKey Only � rotalandtypeof Q 0 �0 <br /> Sampled 5ampfed o <br /> Below Lab 11)Number Sample Description k erx U' REMARKS <br /> 0 SI --©! �' �! <br /> i 1 <br /> I <br /> I <br /> k <br /> C1 C3 2- <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> Relinquishedby Signator Print Name Company pate Time <br /> by s� � � <br /> s-� 7-CO 13 <br /> Received C� /� <br /> Re€inquishedby r1 F}j 7-4V <br /> Received by <br /> v� S J03C) <br /> Relinquishedby <br /> Received by <br /> 'Key: AQ-Aqueous 50•Soil WA Waste OT-Other L-Liter V•Voa S-Soil Jar 0-Oto T-Tedlar B-Brass P-Plastic OT-Other <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 ct€ent expense. The report for the analysis <br /> 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 />
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