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ARCHIVED REPORTS_XR0003831
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003831
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Last modified
3/5/2020 6:22:29 PM
Creation date
3/5/2020 4:31:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003831
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
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SJGOV\sballwahn
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EHD - Public
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. r <br /> . Alpha Analytical, Inc. <br /> Phone: (775)355-1044 FAX;(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 4110102 pate of Notice: 41214211:37:27 AM <br /> Please take note of any Non-Compliant check marks.If we receive no response concerning these items within 24 hours of the date of this <br /> notice,all of the samples will be analyzed as requested. <br /> Client Name Stratus Environmental Project iD: 2007.00651USA 65 <br /> Project Manager: Gowri Kowtha Client's Phone (530)876.6002 Clianvs FAX (530)676-6005 <br /> Work Order Number: STRG2040266 Date Received:412102 Received by: Tracy Degiovanni <br /> Chain of Custody(COCA Information <br /> Carrier name: Golden State OverniQhl <br /> Chain of custody present? Yes ® ❑ No <br /> Custody seals intact on shippping container/cooler? Yes 6 ❑ No Not Present ❑ <br /> Custody seals Intact on sample bottles? Yes 17 f No Not Present h/l <br /> Chain of custody signed when relinquished and received 7 Yes ® ❑ No <br /> Chain of custody agrees with sample lapels? Yes �a ❑ Non-Compliant <br /> Internal Chain of Custody(COC)requested? Yes ❑ ® No <br /> Sub Contract I-ab Used: None ® ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> SShipping containerleooler in good condition? Yes ® ❑ No Not Present ❑ <br /> amples in proper containerlbottle? Yes ® ❑ Nan-compliant <br /> Sample containers intact? Yes ❑Y ❑ No <br /> Sufficient sample volume for indicated test? Yes ® ❑ No <br /> Sample Preservation and Had Time HT)I rmation <br /> All samples received within holding Gme? Yes ® ❑ Non-Compliant <br /> Cooler Temperature <br /> ContainedTemp BlanR temperature in compliance(0-6°C)? Yes V ❑ Non-Compliant 4°C <br /> Water-VOA vials have zero headspece? Yes ❑ ❑ Non-Compliant No VOA vials submitted id <br /> TOC Water-pH acceptable upon receipt? Yes ❑ ❑ No NIA <br /> TOC Samples should have a pt-1<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ ® No <br /> Are there client specific Project requirements? Yes ❑ ® No If YES :see the Chain of Custody(COC) <br /> Comments: <br />
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