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ARCHIVED REPORTS_XR0002602
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARLAN
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15600
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3500 - Local Oversight Program
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PR0545273
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ARCHIVED REPORTS_XR0002602
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Entry Properties
Last modified
2/3/2020 6:36:00 PM
Creation date
2/3/2020 11:13:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002602
RECORD_ID
PR0545273
PE
3528
FACILITY_ID
FA0000174
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15600
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620079
CURRENT_STATUS
02
SITE_LOCATION
15600 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Billing I!nforrilo <br /> CHAIN-OF-CUSTODY RECORD CA !, ,v f of2age r <br /> Alpha Analytical, Inc. WorkOrder : STR03091741 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5773 <br /> Client TEL (775)355-1044 FAX (775)355-0406 Report Due By . 5.00 PM Oil . 25-Sep-03 <br /> Stratus Environmental Gown Kowtha <br /> 3330 Cameron Park Drive TEL (530)676-6002 <br /> Suite 550 FAX (530)676-6005 EDD Requti ed Yes <br /> Cameron Park CA 95682-8861 Job Joes Truck Stop Sampled by Mike <br /> Report Attention Gown Kowtha PO Client's COC# none Cooler Temp 4 °C 17-Sep-03 <br /> CC Report <br /> QC Level S3 = Final Rpt MBLK,LCS MS/MSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL- TPH1E_W TPHIP-W voc-w 4 <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# w Sample Remarks <br /> STR03091741-01A, MW-1_ -AQ 09115/03 8 0 6 MeoHMOH TME-C BTXEIGAS_ BTXFIGAS <br /> 08 53 CIEDBA 2D VEDB/l 20 <br /> CA15oays CAI50cys <br /> STR03091741-02A MW-2 AQ 09/15/03 8 0 6 McOHMOH TPHIE_C BTXP/GAS_'BTXFIGAS <br /> 0836 CIEDBII 2D CIEDB1l 215 <br /> CAISoxys CA15oxys <br /> STR03091741-03A MW-3 AQ 09/15/03 k 8 0 6 WOHMOH TPHIE-C BYXPJGAs BTXDCAS_ - <br /> 08 07 CIEDBII 2D C1E08I1 2D <br /> _ __ CAhorys CA15oxys <br /> STR03091741-04AI MW-4 ^AQ 09115 $ 0 6 McOHIF04 TPHIE-C BTXEIGAS_ BTXEIGAS r <br /> ' <br /> 0750 C/EDR/I 2D MDR/!2D <br /> CA15cxys CA/Soxys <br /> STR03091741-05A' MW-5 AQ 09/15/03 8 0 6 McOHIEtOH TPHIE C BTXFJGAS_ BTXEIGAS_ -----— - T <br /> 0736 I VEDBA 20 C/EDB/l 2D <br /> __ _ CAISoxys CAISoxys <br /> STR03091741-06A MW-6 AQ 09/15103 1 8 0 6 McOH/EtOH TPrI/E_C BTxE/GAS 13TXEJGAS_ <br /> ' <br /> 0722 I CIEDBII 2D�ClEDB/1 2D <br /> __ _ CAhoxys CA75axys <br /> STR03091741-07A M WO-1 X AQ 09/15/03 8 0 6 McOHIEtOH TPHIE_C BTaEIGAS_ BTXEIGAS <br /> 0820 CIEDBII 2D C/EDB/I 2D <br /> CA15o%ys CA15oxys <br /> STR03091741-08A, MWO-1 AQ 09115/03 1 8 0 6 McOMMOH TPHIE_C BTXEIGAS BTXFIGAS_ <br /> l 09 46 C/EDBl1 2D OEM[2D <br /> CA/Soxys CA15oxys <br /> STRO30917I41-09AMWO-2 AQ 09115/03 8 0 6 MCOH D01-1 TPHIE_C BTXEIGAS BTXEIGAS- <br /> 0931 <br /> TXEIGAS0931 CIED1311 20 CIEDBn 2D <br /> CAI"xys CAI>oeys <br /> Comments, Custody seal Frozen ice CA samples EDF ALWAYS send copy of receipt checklist with final report Amended 9/17 2 50 ni-via fax from client Steve Carter,add 5 ox s to all samilles DSB <br /> Sigulture Print Name Company D ite/7line <br /> jReceived by AIpU i An t}IIc2E,In(- <br /> NOTE <br /> ncNOTE 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(Soit) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar 0-Orbe T-Tedlar B-Brass P Plastic OT Other <br />
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