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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: 11/14/2005 Data of Notice; 11/4/2005 10:30:50 <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 wilt be analyzed as requested. <br /> Client Name: Stratus Environmental Project ID: USA 6512007-0065-01 <br /> Project Manager: Gowri Kowtha Client`s EMait: gkowthagstratusinc.net <br /> Client's Phone: (530)676-6001 Client's FAX: (530)676.6005 <br /> Work Order Number: STRO5110404 Date Received: 11/4/2005 Received by: Stephanie Sifuentes <br /> Chain of Custody COC Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes N❑ ❑ No <br /> Custody seals intact on shippping container/cooler? Yes © ❑ 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 © ❑ No <br /> Date and time of collection noted by Client on COC? Yes © ❑ No <br /> Samplers's name noted on COC? Yes No <br /> 0ternal Chain of Custody(COC) requested? Yes ❑ 0 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 containerlbottle? Yes ❑R/ ❑ No <br /> Sample containers intact? Yes © ❑ No <br /> Sufficient sample volume for indicated test? Yes V-1 ❑ No <br /> Sample Preservation and Hold Time H Information <br /> All samples received within holding time? Yes © ❑ No Cooler Temperature <br /> Container/'Temp Blank temperature in compliance (0-6"C)? Yes Ra ❑ No 4'C <br /> Water-VOA vials have aero headspace/no bubbles? Yes ❑ ❑ 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 /> Anal ical 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: AiNTedlars. Chain split due to different TAT's on chain. <br />
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