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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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Entry Properties
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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z <br /> Alpha Analytical, Inc. <br /> Phone:(775)355-1044 FAX:(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 6113102 Date of Notice: 615102 8:35:56 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: 2007.0065-USA 65 <br /> Project Manager: Gsowri Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number: STR02060521 Date Received :615102 Received by: Graciela Navarrete <br /> Chain of Custody(COC)Information <br /> Carrier name: Golden State Overnight <br /> Chain of custody present? Yes Vi No <br /> Custody seals intact on shippping containerlcooler? Yes V; No Not Present <br /> Custody seals intact on sample bottles? Yes No Not Present V <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels? Yes 1;0 ❑ Non-Compliant <br /> Internal Chain of Custody(COC)requested? Yes ❑ ® No <br /> Sub Contract Lab Used : None SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes V No Not Present <br /> Samples in proper container/bottle? Yes N€ Non-Compliant <br /> Sample containers intact? Yes V No <br /> Sufficient sample volume for indicated test? Yes No <br /> Sample Preservation and Hold Time HT Information <br /> All samples received within holding time? Yes ® ❑ Non-Compliant <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6"C)? Yes E7 Non-Compliant °C <br /> Water-VOA vials have zero headspace? Yes ! Non-Compliant No VOA vials submitted W, <br /> TOC Water-pH acceptable upon receipt? Yes No NIA V <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 ❑ No If YES :see the Chain of Custody(COC) <br /> Comments <br />
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