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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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* Page <br /> Billing Infort CHAIN—OF—CUSTRRE <br /> Y <br /> CoRDCA roll <br /> Alpha Analytical, Inc. <br /> 255 Glendale Avenue Suite 21 Sparks Nevada 89431.5778 WorkOrder ; STR05030421 <br /> TEL (775)355-1044 FAX (775)355-0406 Report Due By • 5.00 PM On . 14-Mar-05 <br /> Client Gown Kowtha E . <br /> Stratus Environmental l <br /> TEL (530)676-6002 <br /> 3330 Cameron Park Drive FAX (530)676-6005 EDD Required Yes PDF Required No <br /> Suite 550 EMail gkowtha@stratusinc net <br /> Cameron Park,CA 95682-8861 Sampled 6y D Foland <br /> Report Attention Goren Kowthe Job 2007-0065-011 USA 65 Cooler Temp N/A°C 04-Mar-05 <br /> CC Report PO Client's COC# 08127 <br /> QC Level S3 = Final Rpt,MBLK,LCS, MS/MSD With Surrogates i <br /> Requested Tests - <br /> Alpha Client Collection No of Bottles TPWIP_A voc A <br /> i <br /> Sample ID Sample ID Matrix hate ORG SUB TAT PWS# ! Sample Remarks <br /> STRO5030421-01A Inf T AR 1 03/03/05 1 1 0 1 6 s-rmcmi BTxvo", T Tedlar <br /> 0925 1 <br /> 50xys-c saxys_c <br /> STRO5030421-02A Inf C AR 03/03/05 1 0 6 1 BTXE/rAS/ BTxEmAsr Tedlar <br /> 0920 50xys_C 50xys_c <br /> I <br /> I <br /> Comments Security seals intact Ca sample Coc was 121it into two work orders due to difference in tat requested Send copy of receipt checklist with final report <br /> signature Print Name Company C patefl tme f� <br /> Received by �C, C [�� (��( (.� Alpha Analytical,Inc ] �l�V <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements 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 received by the laboratory with this COC The liability of the laboratory is limited to the amount paid for the report <br /> Matrix Type AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Drrnking Water) OT(Other) Bottle Type 1L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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