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ARCHIVED REPORTS_XR0003846
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LODI
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2500
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003846
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Entry Properties
Last modified
3/5/2020 5:45:22 PM
Creation date
3/5/2020 4:34:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003846
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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f <br /> Billing lnfom* CHAIN-OF-CUST Y RECORDPage <br /> CA f of f <br /> Alpha Analytical, Inc. WorkOrder : STR05011423 <br /> 255 Glendale Avenue,Suite 21 Sparks Nevada 89431 5778 <br /> TEL (775)355-1044 FAX (775)355-0406 Report Due By . 5:00 PM On . 24-Jan-05 <br /> Client Gown Kowtha <br /> Stratus Environmental TEL (530)676-6002 <br /> 3330 Cameron Park Drive FAX (530)676-6005 EDD Required Yes PDF Required No <br /> Suite 550 Email <br /> Sampled by Vince Z <br /> Cameron Park CA 95682-8861 <br /> Report Attention Gown Kowtha Job USA 65 Cooler Temp 4°C 14-Jan-05 <br /> CC Report PO Clienrs COC# 05739 v <br /> QC Level S3 = Final Rpt,MBLK,LCS, MSIMSD With Surrogates <br /> Requested Tests a� <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPHIP w YOG_W <br /> IN <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# _ Sample Remarks <br /> STR05011423-01A MW-1 AQ 1 01/12105 1 5 1 0 6 Meow BTXVC;Ast BTXP1GAs!I <br /> 11 30 EFOH 5oxy5—c saxys_c <br /> STR05011423-02AI MW-2 I AQ 1 01/12/05 1 5 1 0 1 6 1 WOW BTx&GAS/ 8TxE1GASy <br /> 1155 EtOH Soxys_c 50xys_c <br /> STR05011423 03A MW-3 I AQ 1 01/12/05 1 5 0 6 MOW BT}CEIGAS! BTXEIGASI <br /> 1005 EtOH 50xy-c 50xys_C <br /> STR05011423-04AI MW 4 AQ 01112/05 5 0 6 M,0111 BTxEGAsr BTxF1GAs/ <br /> 0930 EtoH 5uxys_c 50xys_c <br /> STR05011423-05A[MW-6 01112105 5 0 6 WOWBTxGAsr BTxErGAs1�� <br /> 09 00 ECOH 5oxys—C soxys_C <br /> i <br /> STR05011423-06A MW-7 AQ 01/12/05 5 0 1 6 1 Mcow BrxE/GAsr BTxEIGAs1 <br /> 0830 EtOH 5uxys_c 5uxys_C <br /> STR05011423-07A MW-8 AQ 1 01/12105 1 5 1 0 1 6 1 WOW I BTXEI(;AS/ BTXF)OAS1 <br /> 1300 EtOH 50xys_c 5uxys_C <br /> 5TR05011423-08A MW-9 AQ 1 01112!05 5 0 6 Meow BTXV(3AS/ 13TxE1GA51 <br /> 11 00 EtOH 50xys_c 50xys_c <br /> STR05011423-09A MW-10 AQ 01112!05 5 0 6 WDIV BTXEfrAsf BTXFiGAs1 _ <br /> 1030 EtOH 50xys-c 50xys_c <br /> STR05011423 <br /> -10A 5-2 AQ 01!3 45 WOW BTW6ASI BTXFIGASI <br /> 1 3 45 5 0 6 EtOH 5axys_C 5ozys_C <br /> }} <br /> Comments Secuity seals intact ice frozen Ca sam les Per faxed amended chain lab s to].gin last sample on chain as"S-2"not"S-1" even though voas have Id of"S I" Send copy of receipt ctiecklist with <br /> final report <br /> 5 n ure Print Name Company 1/I/— Date <br /> fTimge <br /> Alpha Analytical,Inc l-/ f IU� <br /> Received by i p y � <br /> NOTE Samples are discarded 60 days after results are reported unless other a ang�ments 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 rec ived by the laboratory with this COG The liability of the laboratory is limited to the amount paid for the report <br /> Matrix Type AQ(Aqueous) AR(Air) SO(Sotl) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S-Sod Jar O-Orbo T-Tedlar B-grass P-Plastic OT-Other <br /> j I <br />
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