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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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H
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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
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EHD - Public
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Btlling Infome. S Y <br /> �� Page <br /> CHAIN-OF-CUSTODY RECORD CA �, ;�,� , ; , <br /> 2 ore <br /> Alpha Analytical, Inc. WorkOrder : STR03091741 <br /> 255 Glendale Avenue,Sutte 21 Sparks,Nevada 89431-5778 <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 Replied 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 <br /> CC Report 17-Sep-03 <br /> QC Level S3 = Final Rpt,MBLK LCS, MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPH1E_W TPH/P_W voc_w <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# w <br /> Sample Remarks <br /> STR03091741-10A! MWO-3 AQ 09115!03 8 0 6 McOH/EIOH TPH/E-C erxE/cAs BTXE/GAs_ - - <br /> i 10 01 CIEDB11 2D CIEDBA 2D <br /> CA/Soxys CA/5oxys <br /> Comments i` Custod seal Frozen ice CA sam les EDF ALWAYS send Copy of receipt checklist with final re ort Amended 9117,2 Sopm-via fax Irom client Steve Cai ter add 5 ox s to all samples D5B <br /> Signature Print Name Company Datel3 Hue <br /> Received by ` . _ •� Ll'`��' 1 r r ,} > 1' <br /> _ Alph r Au3lytical,Inc <br /> tJ NOSE 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 ciient 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-Soli Jar 0-Orbo T-Tedlar B-Brass P Plastic OT-Other <br />
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