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ARCHIVED REPORTS_XR0003827
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003827
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Entry Properties
Last modified
3/5/2020 6:52:00 PM
Creation date
3/5/2020 4:25:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003827
RECORD_ID
PR0545420
PE
3528
FACILITY_ID
FA0003815
FACILITY_NAME
TESORO (SPEEDWAY) 68154
STREET_NUMBER
2500
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
02740006
CURRENT_STATUS
02
SITE_LOCATION
2500 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Alpha Analytical, lnc.. 3 <br /> i Phone:(775)355-1044 FAX: (775)355-D406 <br /> - Sample Receipt Checklist <br /> Date Report is due to Client: 4/21/2003 Date of Notice: 4!1112003 11:34:59 t <br /> Please take note of any NO check marks.If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested. <br /> ! Client Name Stratus Environmental Project ID 2007-00651 USA 65 <br /> Project Manager: Gowri Kowtha Client's Phone (530)676-6002 Client's FAX (530) 676-6005 <br /> `i <br /> Work Order Number STR03041121 Date Received :4111/2003. Received by: Graciela Navarrete <br /> Chain of Custody!COCl Information <br /> Carrier name California Overnight <br /> Chain of custody present? Yes No <br /> Custody seals intact on shippping containerlcooler? Yes L� LJ No Not Presen ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Presen ❑� <br /> Chain of custody signed when relinquished and received? Yes ❑ No <br /> l ' <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Y <br /> Internal Chain of Custody(GOC)requested ? Yes ❑ n No <br /> Sub Contract Lab Used: None ❑ SEM Other(see comments) ❑ <br /> I' Sample Receipt Information <br /> Shipping containerlcooler in good condition? Yes ❑ No. Not Presen ❑ <br /> samples in proper container/bottle? Yes ❑ No <br /> Sample containers intact? Yes ❑ ❑ No <br /> Sufficient sample volume for indicated test? Yes 0 ❑ No <br /> Sample Preservation and Hold Time(HT) Information <br /> All samples received within holding time? Yesr/❑ ❑ No FFF <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes ❑ ❑ No 4°C <br /> i Water-V0A vials have zero headspace 1 no bubbles? Yes ❑ No No VOA vials submitted <br /> TOC Water-pH acceptable upon receipt? Yes ❑ ❑ No NIA 0 <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ n No If YES :see the Chain of Custody(COC) <br /> Comments <br /> j <br />
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