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ARCHIVED REPORTS_XR0012474
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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3500 - Local Oversight Program
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PR0545336
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ARCHIVED REPORTS_XR0012474
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Entry Properties
Last modified
2/10/2020 8:10:04 PM
Creation date
2/10/2020 4:31:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012474
RECORD_ID
PR0545336
PE
3528
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
02
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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���D HI CHAIN-QF-CUSTOY RECORDPage <br /> APR � � _�� QJ ,5qkll_� i ofi <br /> ou r <br /> Alpha pia Analyt>Ical, Inc. WorkOrder : CAE01041260 <br /> BY; 255 Glendale Avenue,Suite 21 Sparks Nevada 89431-5778 <br /> Client f TEL (775)355-1044 FAX (775)355-0406 Report Due$ 10.00 AM On 13-Apr-01 <br /> Cambna Environmental Tech ,Inc F Company PhonelFax Secondary Phone/Fax <br /> P y <br /> P 0 Box 259 tL (707)935-4850 TEL (707)935-4850 EDD Required No <br /> 270 Perkins Street#259 LAX (707)935-6649 FAX (707)935-6649 <br /> Sonoma,CA 95476 J�o 98995525-W Kettleman Ln,Lodi/Equrva-K Petryna Sampled by Gena Mammini <br /> Report Attention .toe Neely PO Client's COC# none Cooler Temp 4°C 12-Apr-01 <br /> CC Report <br /> QC Level 4 = Final Rpt, MBLK,LCS MSIMSD <br /> Requested Tests <br /> Alpha Client Collection No of Bottles TPHIP-S voc_s <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# Sample Remarks <br /> CAE0104126D-QiA CAT-2-84 ft�50 04!11/01 1 p 1 cis c+c $Txa�i_c <br /> Comments Ca sample Real ice frozen Security seals intact Consultant Project No-243-1346 RUSH'11 24hr TAT' Analyze for all petroleum constituents by EFA method 8260 <br /> Signature -_ Print Name Company + Date/Time <br /> Y --- - <br /> Received ny � /jr►/�/� Q� - _ Alpha Analytical,Inc <br /> ` <br /> NOTE Samples are discarded days after results are reported unless other arrangements are made Hazardous sampls.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 CDC The Lability of the laboratory is limited to the amount pard for the report <br /> Matnx Type AQ(Aqueous) AR(Air) SO(Sod) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B Brass P-Plastic OT-Other <br /> ` I <br /> I <br />
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