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ARCHIVED REPORTS_XR0003854
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_XR0003854
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Entry Properties
Last modified
3/5/2020 6:35:13 PM
Creation date
3/5/2020 4:37:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003854
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 10/31/2003 Date of Notice 1012312003 1D 11 45 <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 00651USA 65 <br /> Project Manager Gown Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR03102342 Date Received 1012312003 Received by Dolly S Baker <br /> Chain of Custody GOC Information <br /> Carrier name FedEx <br /> Chain of Custody present? Yes V U No <br /> Custody seals intact on shippping container/cooler? Yes i16 FJ No Not Presen U <br /> Custody seals intact on sample bottles? Yes U U No Not Presen [J <br /> Chain of custody signed when relinquished and received? Yes L U No <br /> Chain of custody agrees with sample labels? Yes F ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ W!�F No <br /> Sub Contract Lab Used None iu U SEM Other(see comments) ❑ <br /> Sample_ Receipt information <br /> Shipping contamerlcooler in good condition? Yes WJ U No Not Presen U <br /> Samples in proper containerlbottle? Yes L U No <br /> Sample containers intact? Yes 11�_6 U No <br /> Sufficient sample volume for indicated test? Yes ❑I/ ❑ No <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes L-11 ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes E ❑ No NAQC <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ ❑ No No VOA vials submitted Ci <br /> TOC Water-pH acceptable upon receipt? Yes ❑ U 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 ❑ No If YES see the Cham of Custody(COC) <br /> Comments <br /> 0 <br />
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