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ARCHIVED REPORTS_XR0003858
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_XR0003858
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Entry Properties
Last modified
3/5/2020 5:29:29 PM
Creation date
3/5/2020 4:39:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003858
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
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SJGOV\sballwahn
Tags
EHD - Public
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Billing lnfonnation: - — --— — - — - ---- A Page: <br /> CHAIN-OF-CUSTODY RECORD rte' 1 or r . <br /> Alpha Analytical, Inc. <br /> WorkOrder : STR05041121 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> TEL:(775)355-1044 FAX:(775)355-0406 Report Due By : 5:00 PM On : 19-Apr-05 <br /> Client I Gowri Kowtha <br /> Stratus Environmental ;TEL: (530)676-6002 x <br /> 3330 Cameron Park Drive I FAX: (530)676-6005 ! EDD Required: Yes PDF Required:No <br /> Suite 550 ! EMailkowtha stratusinc.ne <br /> 9 @ <br /> Cameron Park,CA 95682-$861I Sampled by:Vince Z. <br /> -----�-�� ---- <br /> Report Attention. Gowd Kowtha Job: USA 65 Cooler Temp: — 4°C 11-Apr-05 <br /> CC Report: PO: Client's COC#: 0664$ <br /> QC Level: S3 = Final Rpt,MBLK,LCS, MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No.of Bottles 1ALCOHOL_ TPH/P_W voC w <br /> ! <br /> Sample ID Sample 10 Matrix Date ORG SUB TAT PWS# w Sample Remarks <br /> STR05041121-01AI MW-1 AQ 04/07/05 5 0 6 M�oHr HTXE/GASr azxE/Gnsr — — <br /> 46:46 EtOH 5oxys_C Soxys C <br /> ! ; <br /> STR05041121-02A MW-2 AQ 04/07/05 5 0 6 ; WOHr BTXEIOASr BTXEIGASIj ! <br /> DOH 50xys_C 50xys–C 1 I ! <br /> 06:17 <br /> STR05041121-03A� MW-3 AQ 04/07/05 5 0 6 WOHI BTxr/GASr BTxF/GAsrI <br /> M 09:22 EtOH 50xys_c 15oxys_C i <br /> r <br /> STR05041121-04AI MWS WOH BTXE/GAV BTxFJcAV AQ 04/47/05 ' S 0 6 EtOH 50xys_c 50xys_c ; <br /> 08:57 <br /> STR05041121-05A� MW-6 j AQ 04/07/05 S 0 6 ( McOH/ BTXE<GAsr BTXEicAV' — <br /> ! 48:29 I EtOH 50xys_c 50xys_c 1 <br /> STR135041121-06Aj MW-7 AQ 04/07/05 5 0 6 WON srxErcAV BTxFJGASI <br /> !!- 08:03 EtOH 50xy5-c 5axys-c I ; <br /> :STRO5041121-07A MW-8 AQ 04/07/05 ` 5 0 6 NWHI BTMC;A-'+ BTx�GASr <br /> I 45:30 - EtOH 50xys–C 5oxy5_C <br /> STR05041121-08A MW-9 AQ 04/07/05 'i 5 0 6 —HI BTXFJGASr BTXVGASI i <br /> 07:06 EtOH 50xys_c 50xys_c I I <br /> STRO5041121-09A! MW-10 AQ 04107/05 5 0 6 &OHI BTMGAS/ srxFJcAS/i i I <br /> I 07:26 EtOH 50xy:_c soxys c ! <br /> STR05041121-1 QA S-2 AQ 04!07105 ' 5 0 6 McOHI BTxE<GASI BTxE/GAsr ! <br /> l <br /> 04:41 EtOH _ <br /> 5oxysC 5nxys_c I <br /> I � � � ! ' <br /> Comments: Securi seals intact.Send copy of receipt checklist with final r ort.Saturday shipment,samples kept 4'C in secured area until logged in on Monday.Ca samples. <br /> Signature i Print Name Company j DatelTime <br /> -- - -- <br /> Received by: Alpha Analytical, <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 COC.The liability of the laboratory is limited to the amount paid for the report. <br /> Matrix Type: AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type: L-Liter V-Voa S-Soil Jar O-Orbo T-Ted€ar B-Brass P-Plastic OT-Other <br />
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