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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 Info CHAIN-O&CUSTAY RECORD <br /> Page <br /> CA 101`1 <br /> Alpha Analytical, Inc. WorkOrder : STR04110528 <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 <br /> Client _ ---- TEL (775)355-1044 FAX (775)355-0406 Report Due By . 5:00 PM On . 15-Nov-04 <br /> Stratus Environmental Gown Kowtha <br /> 3330 Cameron Park Drove TEL (530)676-6002 <br /> Suite 550 FAX (530)676-6005 EDD Required Yes <br /> Cameron Park CA 95682-8861 Job USA 65 Sampled by C Hill <br /> Report Attention Gown Kowtha PO Client's COC# 08381 Cooler Temp NIA°C <br /> CC Report 05-Nov-04 <br /> QC Level S3 = Final Rpt,MBLK,LCS MS/MSD With Surrogates <br /> Requested Tests — <br /> Alpha Client Collection No of Bottles <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# <br /> Sample Remarks <br /> 1A INF Air AR 11/04/04 1 _T 0 6 t eTWGAS/ HTxE/GAS/ <br /> STR04i 10528 0 - - - <br /> — -- �——� � 0504 i Mtbe_C I Mi6e_C - <br /> 5TR04110528-02A�SINF Air AR � 11/04/04 1 0 6 srxrJGAsr BTXMASJ <br /> 0502 MtbcM[h <br /> _C e C I <br /> Comments Security seals intact Ca sam les Coc was split into two work orders due to difference to tat required Send co y.of receipt checklist with final report <br /> _Signature _ _ PrmtName I Company <br /> __� _ DatelTime <br /> Received by - _ �r� �__ Alpha Analytical,Inc G�` ' <br /> I <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(Soil) WS(Waste) OW(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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