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ARCHIVED REPORTS_XR0003857
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_XR0003857
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Entry Properties
Last modified
3/5/2020 6:11:27 PM
Creation date
3/5/2020 4:38:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003857
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: 10/31/2005 Date of Notice: 10121/20053,43:37 <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 : 2007-065-011 USA 65 <br /> Project Manager: Gown Kowths Client's EMail: gkowtha@stratusinc.net <br /> Client's Phone: (530)675-6001 Client's FAX: (530)676-6005 <br /> Work Order Number: STRO5102131 Date Received: 10/21/2005 Received by:Graciela Navarrete <br /> Chain of Custody COC Information <br /> Carrier name: FedEx <br /> Chain of custody present? Yes © ❑ No <br /> Custody seals intact on shippping container/cooler? Yes ❑r/ ❑ 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 /> Sample ID noted by Client on COC? Yes R ❑ No <br /> Date and time of collection noted by Client on COC? Yes RJ ❑ No <br /> Samplers's name noted on COC? x Yes © ❑ No <br /> ernal Chain of Custody(COC)requested? Yes ❑ W No <br /> Sub Contract Lab Used: None 0 ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes 0 ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ No <br /> Sample containers intact? Yes 0 ❑ No <br /> Sufficient sample volume for indicated test? Yes ❑ No <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes © ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes 0 ❑ No 4oc <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes 0 ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA <br /> Analytical Re uirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ No If YES:see the Chain of Custody(COC) <br /> Comments <br />
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