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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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10476
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3500 - Local Oversight Program
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PR0545390
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/5/2020 10:30:17 AM
Creation date
3/5/2020 9:00:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545390
PE
3528
FACILITY_ID
FA0003109
FACILITY_NAME
COUNTRY MARKET
STREET_NUMBER
10476
Direction
W
STREET_NAME
LINNE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25312030
CURRENT_STATUS
02
SITE_LOCATION
10476 W LINNE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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� 21 <br /> Billing Information : CHAIN-OF-CUSTODY RECORD (\,/'wA Kill ' 1 f1 <br /> Alpha Analytical, Inc. WorkOrder : ALSR14030442 <br /> 255 Glendale Avenue, Suite 21 Sparks, Nevada 89431-5778 <br /> TFL: (775) 355-1044 FAX: (775) 355-0406 Report Due By : 5:00 PM On : 1S-Mar-14 <br /> Client: Report Attention Phone Number eMall Address <br /> Ardea Group Nicole Persaud (407) 758-3428 x niccle.persaud@ameagmup.com <br /> 1155 N. First Street, Suite 201 EDD Required : Yes <br /> Sampled by : S. Morden <br /> San Jose, CA 95112 <br /> Cooler Tamo Samples Received Date Printed <br /> PO : CTRYMRT.001 04-Mar-14 10-Mar-14 <br /> Client's COC # : 16406 Job : CTRYMRT/CTRYMRT Phase II 3 °C <br /> QC Level : S3 = Final Rpt, MBLK, LCS, MS/MSD With Surt )gates <br /> Requested Tests <br /> Alpha Client Collection No. of Bottles aero a Team-s TPxm_W voc_a va w <br /> Sample ID Sample ID Matrix Date Alpha Sub TAT Sample Remarks <br /> AL514030442-01A SB-td 10.0 SO 0221110 1 0 10 Tb onsc arxPnu c <br /> 10:50 <br /> ALS14030442-02A SB-1d20.0 SO 0228114 1 0 1Q Pb cns-c sTXalbt� <br /> 1130 <br /> ALS14030442-03A 86-2d 5.0 SO 02ir2 1 0 10 eb ansc erxF.rtn_c <br /> 11 :50 <br /> ALS14030442-04A SB-2d 10.0 SO 0228/14 1 0 10m cAs-c aTxmta_c <br /> 11 :55 <br /> ALS14030442-05A GW-1 AQ 0228114 3 0 10 cns-c e1'XPlht c <br /> 13:10 <br /> Coments: Seenrity seals intact Frozen ice Total Xylenes Amended 3/IO/14 to correct VOC semoling state, doe to loan error. SN <br /> m <br /> Signature - Priat Name Company Date/Fime� p� <br /> / Alpha Analytical, Inc. <br /> Logged in by: <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 /> Mabbr Type : AQ(Aqueous) AR(Air) SO(Soil) WS(Wasta) DW(Ddnking Water) OT(Other) Bonle Type: L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT4xher <br />
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