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ARCHIVED REPORTS XR0006978
Environmental Health - Public
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EHD Program Facility Records by Street Name
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103
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3500 - Local Oversight Program
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PR0544638
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ARCHIVED REPORTS XR0006978
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Last modified
7/9/2019 2:55:13 PM
Creation date
7/9/2019 2:19:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006978
RECORD_ID
PR0544638
PE
3528
FACILITY_ID
FA0004027
FACILITY_NAME
HENDRIX FORK LIFT INC
STREET_NUMBER
103
Direction
N
STREET_NAME
E
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15318001
CURRENT_STATUS
02
SITE_LOCATION
103 N E ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Billing tnforrnation CHAIN-OF-CUSTODY RECORD CA Page 9 of i <br /> Alpha Analytical, Inc. WorkOrder : STR05092103 <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 • 29-Sep-05 <br /> Client Steve Carter <br /> Stratus Environmental TEL (530)676-6008 <br /> 3330 Cameron Park Drive FAX (530)676-6005 EDD Required Yes <br /> Suite 550 EMail scarter@stratusinc net <br /> Sampled by C Hill <br /> Cameron Park,CA 95682-8861 <br /> Report Attention Steve Carter Job Cooler Ternp 4°C Date Printed <br /> CC Report PO Client's COC# 09554 21-Sep-05 <br /> QC Level S3 = Final Rpt,MBLK,LCS,MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles TPWP W voC w <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# Sample Remarks <br /> STRO5092103-01 MW-13 AQ 1 09/20/05 5 0 6 GAS-c BTEwoxvr <br /> 0831 i,2ocAren <br /> BC <br /> STRO5092103-0MW-14 AQ 09120/05 5 0 6 GAS-C BTEwaxv! <br /> 0905 1'2DCAIED <br /> BC <br /> STROW92103-03 AS-1 AQ 09/20/05 5 0 6 GAS-C BTEx10xY! <br /> 08 45 i 2DCAJED <br /> BC <br /> Comments Security seals intact,frozen ice Send copy of recerot checklist with final revort <br /> Print Name Company Date!)(ime <br /> Srgnatur$ <br /> Received by t�J j' - c _C s:_� ` - - -f� r Alpha Analytical,Inc <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples wd1 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(Dnnking Water) OT(Other) Bottle Type L-Liter V-Voa S-Sad Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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