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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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0No , • <br /> Billing lnfarn, n 1* _ <br /> CHAIN-OF-CUSTODY RECORD Page , <br /> CA 2of2 <br /> Alpha Analytical, Inc. WorkOrder : STR03091741 <br /> 255 Glendale Avenue,Suite 2 t Sparks,Nevada 89431-5778 <br /> Client TEL (775)355-1044 FAX (775)355-0406 Repo><t Due By . 5 00 PM On 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 Required Yes <br /> Cameron Park CA 95682-8861 Job Joes Truck Stop Sampled by Mike <br /> Report Attention Gown Kowtha PO Clients COC# none <br /> CC Report Cooler Temp 4°C 17-Sep-43 <br /> QC Level S3 = Final Rpt,MBLK,LCS,MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPH1E_W TPHIP_W VOC_w <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# w <br /> _ Sample Remarks <br /> 5TR03091741-10A WM Q-3 AQ 09115/03 8 0 6 McOHMotl TPHrE_C BTxE/GAs_ BTXEicAs_ -1001 CIEDB11 2D CIEDBIi 2D <br /> CA CA <br /> i <br /> Comments Custody seal Fiozen ice CA saimfles EDF ALWAYS send copy o£receipt checklist with final re ort <br /> Signature Pant Name <br /> Comp m} bate/"!uue <br /> i <br /> Received by <br /> Alph.i Ali it}tical,I nc <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 liabtitty 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-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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