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ARCHIVED REPORTS_XR0003828
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003828
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Entry Properties
Last modified
3/5/2020 5:32:32 PM
Creation date
3/5/2020 4:29:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003828
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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11-12-02: 11 :03 ;Alpha Analyticol ;775 355 0406 2 <br /> Alpha Analytical, Inc. <br /> Phone:(775)355-1044 FAX:(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Reportis due to Client: 11120!02 Date of Notice: 1111210210:33:12A <br /> Please take note of any NO check marks.If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested. <br /> Client Name Stratus Environmental Project ID: 2007-00651 USA 65 <br /> Project Manager: Gowrl Kowtha Client's Phone (530)676.6002 Client's FAX (530)576-6005 <br /> Work Order Number; STR02111220 date Received:11112102 Received by: Graciela Navarrete <br /> Chafe of Custody[COC]Information <br /> Carrier name: FedEx <br /> Chain of custody present 7 Yes ® ❑ No <br /> Custody seals intact on shippping containedcooler? Yes ® ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes ® ❑ No <br /> Chain of custody agrees with sample labels? Yes ® ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ ❑C No <br /> Sub Contract Lab Used: None ® ❑ SEM Other(sea comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes ® ❑ No Not Present ❑ <br /> Samples in proper containeribottle? Yes ® ❑ No <br /> Sample containers intact? Yes ® ❑ No <br /> Sufficient sample volume for indicated test? Yes ® ❑ No <br /> Sample Preservation and Mold Time N Information <br /> All samples received within holding time? Yes ® ❑ No Cooter Temperature <br /> Containerlremp Blank temperature in compliance(0-6°C)? Yes ® ❑ No 4°C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ® ❑ No No VOA vials submitted ❑ <br /> TOC Water-pH acceptable upon receipt? Yes ❑ ❑ No NIA <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modiried methods requested 7 Yes �� 1[� No <br /> Are there client specific Project requirements? Yes i.. No If YlrS:see the Chain of Custody(COC) <br /> Comments <br /> • <br />
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