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ARCHIVED REPORTS_XR0003854
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LODI
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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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� i s <br /> Billing Information <br /> CHAIN-OF-CUSTODY RECORD Page - <br /> CA f oft <br /> Alpha Analytical, Inc. WorkOrder : STR03102342 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431 5778 <br /> Client TEL (775)355-1044 FAX (775)1355-0406 Report Due By . 5 00 PM On 31-Oct-03 <br /> Stratus Environmental Gown Kowtha <br /> 3330 Cameron Park Drive TEL (530)676-6002 <br /> Suite 550 FAX (530)676-6005 EDD Required Yes <br /> Cameron Park,CA 95682-8861 ,lob 2007 0065/USA 65 Sampled by C Hill <br /> Report Attention Gown Kowtha PO Client's COC# 2421 <br /> CC Report Cooler Temp NA°C 23-Oct-03 <br /> QC Level S3 = Final Rpt,MBLK LCS MSIMSD With Surrogates <br /> Alpha Client Collection No of Bottles TPHIP_q voc_n Requested Tests <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# <br /> STR03102i Sample RemarksAR 10/22/03 1 <br /> 0 6 BTXE/GAS_ BrxFtGAs -T-- ---- i <br /> I <br /> 1404 05nxy5 G5uxys - Tedlar bag <br /> STR03102342-02A MID Air ' AR 10/22/03 1 1 0 6 aTxE/GAs_ sTxE/GAs <br /> I 14 02 GSoxys Cr5oxys Tedlar bag <br /> STI103102342-03A EFF Air AR 10122!03 f 0 6 erxi ows_ arxcAs_ <br /> 1400 ; C5oxys G5oxys Tedlar bag <br /> I <br /> Comments Custody seal No ice needed CA samples Send corly of recei t checklist with final re ort <br /> Signature <br /> Print Name Company <br /> 'DatelTime <br /> h Received by Alpha Analytical,Inc <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 client expense <br /> The report for the analysis of the above samples is applicable only to those samples received by the laboratory with this GOC The liability of the laboratory is limited to the amount pard for the report <br /> Matrix Type AQ(Aqueous) AR(Air) SO(Soll) WS(Waste) DW(Dnnking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar 8-Brass P-Plastic OT-Other <br /> I <br />
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