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ARCHIVED REPORTS_XR0003834
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003834
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Entry Properties
Last modified
3/5/2020 6:01:23 PM
Creation date
3/5/2020 4:32:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003834
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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J. <br /> -4. <br /> Alpha Analytical, Inc. <br /> Phone; (775)355-104-4 FAX : {775)355-0406 r <br /> i • <br /> f Sample Receipt Checklist <br /> Date Report is due to Client: 1116102 Date of Notice: 119102 10:29:23 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 : 2007.0651USA 65 ,r; <br />` lProject Manager: Gowri {owthaClient's Phone (530)fi76-6002 Client's <br /> FAX (530)fi76-6005 _ <br /> Work Order Number: STR02010961 Date Received:119102 Received by: Tracy Degiovanni <br /> Chain of Custody COC Information .�. <br /> Carrier name: Golden State Overnight <br /> I <br /> Chain of custody present? Yes ❑ No <br /> Custody seals intact on shippping container/cooler? Yes wI J No Not Present <br />` Custody seals intact on sample bottles? Yes ❑ _J No Not Present ,✓ <br /> i <br /> Chain of custody signed when relinquished and received ? Yes ❑ No <br /> I»;aa <br /> Chain of custody agrees with sample labels? Yes Non-Compliant , <br /> Internal Chain of Custody(COC)requested? Yes ❑ No <br /> Sub Contract Lab Used : <br /> None � ❑ SEM Other(see comments) <br /> Sample Receipt Information KA <br /> {J <br /> hipping container/cooler in good condition? Yes ❑ No Not Present 1—i i c•;� <br /> Samples in proper containerlbottle? Yes -S�5 ❑ Non-Compliant <br /> Sample containers intact? Yes No l' <br /> i <br /> Sufficient sample volume for indicated test? Yes �Yl' LJ No <br /> Sample Preservation and Hold Time H7 Information <br /> All Samples received within holding time? Yes V ❑ Non-Compliant "''•'.: <br /> Cocfer Temperature <br /> ContainerrTemp Blank temperature in compliance(0-6'C)? Yes Non-Compliant 4-C 1' <br /> Water-VOA vials have zero headspace? Yes ❑ 'J Non-Compliant No VOA vials submitted <br /> TOC Water-pH acceptable upon receipt? Yes ! �_ No NIA <br /> i...-fir. <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 !! Y No If YES :see the Chain of Custody(COC) i... � <br /> i.. <br /> Comments <br /> "'IT <br />
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