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ARCHIVED REPORTS_XR0013037
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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_XR0013037
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Entry Properties
Last modified
3/5/2020 5:50:47 PM
Creation date
3/5/2020 4:58:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0013037
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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a <br /> �"Alpha.Anal}tical, Inc. <br /> Phone:(775)355-1044, FAX:(775)355-0406 <br /> L/ <br /> . .Sample Receipt Checklist <br /> Date Report is due to Client: 811212003 Date of Notice: 81412003 9:14.75 A <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 /> T <br /> Client Name Stratus Environmental Project ID: USA 56' <br /> Project Manager. Gowri Kowtha Client's Phone (530) 676-6002 Client's FAX (530) 676-6005 <br /> Work Order Number STRO3080202 DateliReceived:812/2003 Received by: " Graciela Navarrete <br /> .:Chain of Custody[COG)Information <br /> 7 <br /> Carrier name FedEx <br /> j . <br /> Chain of"custody present? Yes No <br /> Custody seals intact on shippping containerlcooler? Yes 23 ❑ No Not Presen ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Presen ❑� <br /> Chain of custody signed when relinquished and received.? Yes LI ❑ No <br /> Chain of custody agrees with sample labels? . Yes ❑" No <br /> Internal Chain of Custody(COC)requested?" Yes No <br /> Sub Contract dab Used: None (J ❑ SEM Other(see comments) ❑ <br /> " Sample Receipt Information <br /> Shipping container cooler in good condition? Yes Cl/I ❑ No Not Presen ❑ <br /> Samples in proper containerlbottle? Yes No <br /> Sample containers intact? j;, Yes CJ ❑. No <br /> I Sufficient sample volume for indicated test? Yes" ® ❑ No <br /> i <br /> Sample Preservation and„Hold Time(HT)Information <br /> i <br /> All samples received within holding time? Yes ❑ No <br /> Cooler Temperature <br /> ContainerfTemp Blank temperature in compliance(0-6°Ci)? Yes ❑ No 4°C <br /> Water-VOA vials have zero headspace 1 no bubbles? '. Yes ❑ ❑ No No VOA vials submitted ©" <br /> TOC Water-pH acceptable upon receipt? Yes ❑ ❑ No NIA l" ' <br /> TOC Samples should have a pH�2(H2SO4) <br /> AnalVtical Requirement information <br /> Are non-Standard or Modified methods requested? r. Yes ❑ `❑ No <br /> Are there client specific Project requirements? Yes ❑ 0 No If YES:see the Chain of Custody(COC) <br /> Comments: <br /> i <br />
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