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ARCHIVED REPORTS_XR0003829
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003829
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Entry Properties
Last modified
3/5/2020 6:34:21 PM
Creation date
3/5/2020 4:29:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003829
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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Alpha Analytical, Inc. <br /> Phone:(775)355-1044 FAX;(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 8/21102 Date of Notice: 8114102 10:58:11 AM <br /> Please take note of any Non-Compliant check marks. If we receive no response concerning these Items within 24 hours of the date of this <br /> notice,all of the samples will be analyzed as requested. <br /> Client Name Stratus Environmental Project ID: 2007-00651 USA 65 <br /> Project Manager: Gowri Kowtha Client's Phone (530)676-6402 Client's FAX (530)676-6005 <br /> Work Order Number: STR02081424 Date Received :8114102 Received by: Graciela Navarrete <br /> Chain of Custody(COC)Information <br /> Carrier name: Golden State Overnight <br /> Chain of custody present? Yes FVJ ❑ No <br /> Custody seals intact on shippping containericooler? Yes l/j E No Not Present !� <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes V ❑ No <br /> Chain of custody agrees with sample labels? Yes ® ❑ Non-Compliant <br /> Internal Chain of Custody(COC)requested? Yes ❑ ® No <br /> Sub Contract Lab Used: None ® ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes 7VI ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes 1VJ ❑ Non-Compliant <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated test? Yes W] ❑ No <br /> Sample Preservation and Hold Time HT information <br /> All samples received within holding time? Yes ❑ Non-Compliant <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes ❑ Non-Compliant 4O <br /> Water-VOA vials have zero headspace? Yes ❑ Non-Compliant No VOA vials submitted ❑ <br /> TOC Water-pH acceptable upon receipt? Yes ❑ n No N!A <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ ® No <br /> Are there client specific Project requirements? Yes ❑ LI/ No If YES:see the Chain of Custody(COG) <br /> Comments: <br />
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