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ARCHIVED REPORTS_XR0002620
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_XR0002620
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Entry Properties
Last modified
2/3/2020 6:26:49 PM
Creation date
2/3/2020 11:19:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002620
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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Billing Inform * Page <br /> CACHAIN-OF-CUSTAY RECORD <br /> 1 of 2 <br /> Alpha Analytical, Inc. WorkOrder : STR04120640 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> Client <br /> TEL (775)355-1044 FAX (775)355-0406 Report Due By : 5.00 PM On : 14-Dec-04 <br /> Stratus Environmental Gown Kowtha <br /> 3330 Cameron Park Drive TEL (530)676-6002 EDD Required Yes <br /> Suite 550 FAX (530)676-6005 <br /> Cameron Park CA 95682-8861 Job Joes Truck Plaza Sampled by Vince Z <br /> Report Attention Gown Kowtha PO Client's COC# 05754 Cooler Temp 4 OC 06-Dec-04 <br /> CC Report <br /> QC Level S3 = Final Rpt MBLK,LCS MSIMSD With Surrogates <br /> Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPHIE_w TPHIP_W VOC W <br /> w <br /> Sample ID Sample ID Matrix Date 0RG SUB TAT PWS# <br /> i � Sample Remarks <br /> STR04120640-01A MW-1 AQ 12/02/04 9 0 6 McOHIWH TPHIE_C BTXFJGAS_ BTXE/GAS _ <br /> 1245 C15oxys/EDn CI5ox5s/EDB <br /> ll2DCA 112DCA <br /> STR04120640-02A MW-2 AQ 12102/04 9 0 6 McOH DOH TPHIE C BTXE/GAS_ BTXEIGAS_ <br /> 0650 I Mocys,EDBICISoxy-dEDB <br /> 112DCA /I 2DCA <br /> STR04120640-03A, MW-3 AQ 12/02/04 9 0 6 Me0H/E10H TPHIE_C BTXEIGAS BTXEIGAS <br /> 11 00 C15oxWEDB C/5oxys/EDB <br /> 112DCA 112DCA <br /> STR04120640-04A, MW-4 AQ 12102/04 9 0 6 McOII/EIOH TPWE_c BTxE/GAs BTXEIGAS ---- <br /> 11 36 ClSoxy57EDB ClSoxyslEDB <br /> ll2DCA 112DCA <br /> STR04120640-05A' MW-5 AQ 12/02/04 9 0 6 Mc01-11Et01-1 TPH/E_C BT TIGAS_ BTXEIGAS <br /> 1205 C/%xys1FDB ClSoxys/EDB <br /> 112DCA 112DCA <br /> STR04120640-06A MW-6 AQ 12/02/04 90 6 I McOH/EIOH TPHIE_C BTXEIGAS_ BTXEIGAS <br /> 13 20 C15oxyslEDB C75nxys/FDB <br /> ll2DCA 112DCA <br /> STR04120640-07A MW-7 AQ 12/02/04 9 0 6 WOHIDOH TPHIE-C BTXEIGAS BTXE/GAs <br /> 10 30 0Soxys/FDB CRoxys DB <br /> 112DCA 112DCA <br /> STR04120640-08A MWO-1X AQ 12/02/04 9 0 6 I WOHMOH TPHIE_C BTXEIGAS BTXEIGAS <br /> 0738 C/50xys1ED6 C/%xjs/EDB <br /> '12DCA 112DCA <br /> STR04120640-09A' MWO-2 AQ 12/02/04 9 0 6 McOHIMH TPHIE_C BTXEIGAS BTXE/GAS <br /> 09 45 C15oxy5 EDB a5oxysrEDB <br /> It 2DCA 11 2DCA <br /> Comments Samples received 12104/04,sales kept cold&secure until log-in Custody seal Frozen ice Send copy of receipt checklist with final report <br /> Signature Print Name Compan% Date/Time <br /> Received by `7 !k��J� Alpha Anahtical,Inc j a/[►[..k- <br /> "l I <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 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(Drinking 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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