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ARCHIVED REPORTS_XR0003858
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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L
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LODI
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2500
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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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6illitti An , <br /> atiori: Samples Collected From Which State? <br /> 9 +� Alpha lytical, Inc. AZ CA fC NV_ WA_ <br /> Name 7�3to v �_ 255 Glendale Avenue,Suite 21 !D OR— OTHER Page#_� <br /> Address c3�3t) PX Dom. 5+.,'T �S 0 Sparks,Nevada 89431-5778 -- -of-L-- <br /> City,State.Zip Cu!,ti.-t jpC Ca 'T (.rZ Phone (775)355.1044 <br /> Phone Number33-0 4 7A Laoy t=ax S30 1-71-1003` Fax {775)355-0406 Analyses Required -, 0 <br /> Client Name P.O.>k Job++ <br /> M S 19 1151p0 - e at,r-a Required QC Level? <br /> Address Entail Address <br /> city,State,Zip 11 !ll lY <br /> Phone Fax a ,, — <br /> Mat t1iCe .h. Sa dtyy. Re rtAttenti0r r V EDD/EDF7YE5� ND <br /> Time (}ale Total and type o, C <br /> Sampled Sampled See Key Cnly f+ `� °We �Oie4 containers Q In Glo6allU�TDCO7706 8 <br /> Below Lab ID Number Sample Description TAT Fuemd "See below REMARKS <br /> ARO,:SIV. OT DSDS t2A - 01 W.% C A !Fl F S ! i <br /> 10 ! 4 4 b-ja %/J,I.t,t 57-4'r <br /> Vv"'4 ,w t v-&i 4 ;z'i la- <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> i <br /> 5i nature Print Name Company Date Time <br /> Reb-nquished � <br /> rik cm U. <br /> Receivedby t�E.O <br /> Relinqu"shed by <br /> Received by <br /> �izL�s 1a cc <br /> ReInquis^ea b} <br /> Received by - -- <br /> 'Key: AQ-Aqueous SO-Soil t'JA-waste OT-Other ': L-Liter V-'Joa S-Soil Jar 0-0rbo T-Tedtar S-Erass P-Pia t, O -Other <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 ai cilFnt expense. The teeort ID,the analysis <br /> of the above samples is applicable cnly to those samples received by the laboratory with this coc. The liability et the laboratory is limited to the amount paid for the repo,! <br />
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