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ARCHIVED REPORTS XR0006985
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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103
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3500 - Local Oversight Program
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PR0544638
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ARCHIVED REPORTS XR0006985
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Entry Properties
Last modified
7/9/2019 3:22:11 PM
Creation date
7/9/2019 2:22:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006985
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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is 0 <br /> Billing lnFo*n Pae <br /> 1Gf� _ <br /> CIRAIN-OF-CUSTODY RECORD CA g <br /> Alpha Analytical, Inc. WorkOrder • STR03091124 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431 5778 <br /> Client TEL (775)355 1044 FAX (775)355-0406 Report Due By 5 00 PM Oil 19-Sep-03 <br /> Stratus Environmental Jay Johnson <br /> 3330 Cameron Park Drive TEL (530)6 76-600 <br /> 530)676-600EDD Replied Yes <br /> Suite 550 FAX (530)676-6005 <br /> Cameron Park,CA 95682-8861 Job 2001-01031 Tetchert Sampled by C HIII <br /> Report Attention Jay Johnson PO Client's COC# 3723 Cooler Tcmp 4 °C 1 1-Sep-03 <br /> CC Report <br /> QC Level S3 = Final Rpt,MBLK,LCS, MSIMSD With Surrogates <br /> Requested Tesfs---- -- -----��--� _ - -- — <br /> Alpha Client Collection No of Bottles I TPHlP W voc w --- i--- i- ___ <br /> Sample ID Sample ID Matrix pate ORG SUB TAT PWS# <br /> Sample Remarks <br /> STR03091124-01A MW-13 AQ09!10!03- I——6-- 0 6 BTxFIGASI BTXP;GAS/ I I <br /> a9 2020 5ox�,i z I Sox, 12 <br /> DCA! DCN <br /> _ <br /> LL <br /> EDB_C IEDB_C <br /> 17 AQ 0911 !_03- ---T— TTXFJGAsiITxGA <br /> S/R91— -2W-1--I I --r <br /> t - 5ozysJ12 Sazys/l2 ---- — i I <br /> I I <br /> DCA/ DCAI <br /> EDB C i;DB C <br /> 1 STR03091124-03A ASA I AQ 09/10/03 6 0 6 13TXFJGAS1 BTXFJGASr <br /> 09 42 I 5ozys/i 2 5oays/1,2 , <br /> DCA! DCA! <br /> ---� EDB C EDB C <br /> Comments Security seals intact ice frozen California samples Send cony of receipt checklist with final report <br /> _-- Signature — / Print Name Alpha Analytical,Inc Company Date/Time <br /> �, <br /> I Received by (� — ` (� r)� <br /> '� �� `--`J 1✓ <br /> NOSE Samples are discarded 60 days after results are reported unless other arrangements are trade 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(Drinkmg 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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