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ARCHIVED REPORTS_XR0003849
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003849
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Entry Properties
Last modified
3/5/2020 5:39:53 PM
Creation date
3/5/2020 4:35:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003849
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
Tags
EHD - Public
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Billing InformPage <br /> CHAIN-OF-CUST RECORD CA 1of1 <br /> Alpha Analytical, Inc. WorkOrder : STR04100560 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 y <br /> TEL (775)355-1044 FAX (775)355-0406 — Report Due By : 5:00 PM On 13-Oct-04 <br /> Client <br /> Stratus Environmental Gown Kawtha <br /> 3330 Cameron Park Drive1 TEL (530)676-6002 j EDD Required Yes <br /> Suite 550 ;FAX (530)676-6005 <br /> Sampled by Vince Z <br /> Cameron Park CA 95682-8861 Job USA 65 <br /> Report Attention Gown Kowtha PO Client's COC# 08385 Cooler Temp b'C 05-Oct-04 <br /> CC Report <br /> QC Level S3 = Final Rpt MBLK,LCS,MS1MSO With Surrogates <br /> -- --- --- _ -- - -- ---� -- Requested Tests <br /> Alpha Client Collection No of Bottles ALCOHOL_ TPHIP W VOC W 1 <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# w �� - - - Sample Remarks <br /> p _ <br /> -i -- <br /> i i --'-� -- McOH/EtOH BTXPJGAS_ BTxElGAS_' ��1-- <br /> I STR04100560-01AJ MW 1 AQ 10104!04 5 Q s I G50XYS C150XYS <br /> 1005 <br /> Q .(104104 l 5 McOWEIoH srXEIGAs .GQ As <br /> 050XY5_ SOXYS_ <br /> STR04100560-02A MW-2 A <br /> 1 1045 I i <br /> STR04100560-03A MW-3 { AQ ' 10/04/04 ; 5 0 fi M�is�ioH BC/50xys_ BclsoxyS_� — <br /> I 09 05 � I Gsoxvs crsoxvs <br /> - r <br /> MWRH EtQH BTXFIGASBTXEIGAS_ <br /> _ <br /> ' <br /> �STR04100560-04A` MWS i AQ 10084054 II 5 I 0 �� Gsoxvs Gsoxvs <br /> r- I --' McOWEIOH�BTXEIGAS_ BTXFJGAS_� I <br /> STR0 1160560-OSA MW-6 Ad—,,-16/—o4164 5 0 fi I Gsoxvs Gsoxvs <br /> 0735 <br /> 0 6 McOti 1QH BT 50GAS_ BTXE/GAS_ <br /> 1 STR0410QS60-06A� MW-7 AQ 10/04104 5 I 1 Gsoxvs G5oxys <br /> 1 I 0830 <br /> �STR041005fiQ-07A1 MW-B AQ 'IQ104IQ4 5 O i 6 I McGH1ElOH BCJ50XYS_ BCJ50XYS_ <br /> { TXFJGA GSOXYS <br /> 1135 I <br /> co or recet t checklist with final re art <br /> Comments 5ecunty seals intact frozen ice Send nv n - o <br /> —Print Name Company E DatelTrme <br /> - ay Alpha Analvtiral,Inc (Q Islay <br /> Received by <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 analysts 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(Sotl) WS(Waste) DW(Dnnking Water) OT(Other) Bottle Type L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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