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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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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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> • Sample Receipt Checklist <br /> Date Report is due to Client 31412005 Date of Notice 3/412005 9 54 53 AM <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 2007-0065-011 LISA 65 <br /> Protect Manager Gown Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STRO5030422 Date Received 3/412005 Received by Graciela Navarrete <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes ❑ No <br /> Custody seals intact on shsppping container/cooler? Yes ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received 7 Yes 0 ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Sample ID noted by Client on COC? Yes ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br /> Samplers's name noted on COC? Yes ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ No <br /> Sub Contract Lab Used None ❑ ❑ SEM Other(see comments) ❑ <br /> Sample Recerot Information <br /> Shipping container/cooler in good condition? Yes ❑J ❑ No Not Present ❑ <br /> Samples in proper containeribottle? Yes © ❑ No <br /> Sample containers intact? Yes W ❑ No <br /> Sufficient sample volume for indicated test? Yes W ❑ No <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes 0 ❑ No <br /> Cooter Temperature <br /> ContainerlTemp Blank temperature in compliance(0-6°C)? Yes ❑ No NIA OC <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ ❑ No No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes R] ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA R] <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 Coc was pht into two work orders due to difference in tat requested <br /> • <br />
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