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ARCHIVED REPORTS XR0003350
Environmental Health - Public
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2705
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3500 - Local Oversight Program
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PR0544595
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ARCHIVED REPORTS XR0003350
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Entry Properties
Last modified
6/24/2019 11:38:23 AM
Creation date
6/24/2019 10:55:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003350
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Billing tnfor tion CHAIN—OF—CUSVDY RECORD Page of 2 <br /> • - - CA <br /> Alpha Analytical, Inc. WorkOrder : STR06032745 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> TEL (775)355-1044 FAx (775)355-0406 <br /> Client __v__ _I Report Due By - 5.00 PM On • 03-Apr-06 <br /> i T <br /> Gown Kowtha <br /> Stratus Environmental TEL (530)676-6001 x <br /> 3330 Cameron Park Drive 'FAX (530)676-6005 EDD Requn ed Yes <br /> Suite 550 ; EMail gkowtha@stratusinc net <br /> Cameron Park CA 95682-8861 Sampled by Client <br /> Report Attention Gown Kowtha Job 2007-0835-01/USA835 Cooler Temp Samples Received Date Pnnted <br /> CC Report PO Client's COC# 6833 40C 24-Mar-06 <br /> 27-Mar-t16 <br /> OC Level S3 = Final Rpt, MBLK LCS, MSIMSD With Surrogates <br /> �_ _ Requested Tests <br /> OH <br /> Alpha Client Collection No of Bottles IALCw _OL- <br /> Tpw w TPHIP W VOC_w <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# I _ -- � i I Sample Remarks <br /> 5TR06032745-11A VEW-1 AQ i 03123!06 1 8 1 0 6 i htcOH! I TPH/E c Ens c l>3rewoKYr <br /> O7 30 DOH z pcA_c <br /> IAll voa s recd labeled VW-1- <br /> � - � � l <br /> _ logged in as per chain <br /> STRO6032745-12A VEW 3 AQ 03/23/06 8 0 6 MCOHr TPH/E_c GAS C BTealoXvr _ All vows recd labeled VW-3 { <br /> 07 05 e,oH— — — -- i z pcA c logged an as per chain <br /> I <br /> C omments SCCUrity seals intact Frozen ice Samples received Fri(3124)but not logged in until Mon(3127) Samples kept cold and secure until login Send cony of iecei t checklist with final report <br /> 7port <br /> SiRneture Print Name _ (onipanN Date/Time <br /> Dogged in by - {`` pn Alpha Anal tical Inc 366 4"�7 <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 0 Orbo T Tedlar B-Brass P-Plastic OT-Other <br />
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