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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)355-1 D44 FAX :(775)355-4406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 8121102 Date of Notice: 8114102 10:39:27 AMI <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: 2007-0651 USA 65 <br /> Project Manager: Gowri Kowtha Clients Phone (530) 676-6002 Client's FAX (530)676-6005 <br /> Work Order Number: STR02081423 Date Received :8114/02 Received by: Graciela Navarrete <br /> Chain of Custody(COC) Information <br /> Carrier name: Golden State Overnight <br /> Chain of custody present? Yes ii __J No <br /> Custody seals intact on shippping container/cooler? Yes ❑ No Not Present !�.I <br /> Custody seals intact on sample bottles? Yes No Not Present <br /> Chain of custody signed when relinquished and received ? Yes L No <br /> Chain of custody agrees with sample labels? Yes m lJ 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 ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ Non-Compliant <br /> Sample containers intact? Yes M6 J No <br /> Sufficient sample volume for indicated test? Yes 2 ❑ No <br /> -Sample Preservation and Hold Time(HTLnformation <br /> All samples received within holding time? Yes OW ❑ Non-Compliant <br /> Cooler Temperature <br /> ContainerlTemp Blank temperature in compliance(0-6°C)? Yes ] ❑ Non-Compliant 4°C <br /> Water-VOA vials have zero headspace? Yes Non-Compliant No VOA vials submitted <br /> TOC Water-pts acceptable upon receipt? Yes ! No NIA i% <br /> TOG Samples should have a pH<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes U �W No <br /> Are there client specific Project requirements ? Yes ❑ 7 No If YES :see the Chain of Custody(COC) <br /> Comments: <br /> I <br />
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