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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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is <br /> Billing lotion CHAIN-OF-CUSIRDY Page <br /> -- - _-_- �. -- -- -- - - _RECORD CA <br /> 7 of 7 � I <br /> Alpha Analytical, Inc. <br /> 255 Glendale Avenue,Suite 21 Sparks,Nevada 89431-5778 WorkOrder : STR04121061 <br /> Client <br /> TEL(775)355-1044 FAX (775)3_55_-0.406 — Report Due By : 5:00 PM On : 20-Dec-04 <br /> Gown Kowtha <br /> Stratus Environmental TEL (530)676-6002 <br /> 3330 Cameron Park Drive <br /> Suite 550 FAX (530)676-6005 EDD Required Yes PDF Required No <br /> EMad <br /> Cameron Park,CA 95662-8861 - _— Sampled by D Foland <br /> Report Attention Gown Kowtha Job 2007-0065-Ol/USA 65 Cooler Temp NA°C <br /> CC Report PO Client's COC# 06012 10-Dee-04 <br /> QC Level S3 = Final Rpt, MBLK,LCS,MS/MSD With Surrogates <br /> _ Requested Tosts - <br /> Alpha -- Client - Collection No of Bottles Tpitta A voc a E �— <br /> Sample ID Sample ID Matrix Date ORG SUB TAT PWS# Sample Remarks <br /> STR04121061-p1A� INFT— - -�AR 12/09/04 1 0 _6 ix�rcns_ grx�cns_ -- — - --� <br /> 11 25 cmxvs caaxvs -I -� --- TEDLAR <br /> STR04121061-02A I NF C I AR 12/092/004 1 T0� 6 gnc�cws_ grx�ons_ -- — <br /> Croxvs mxvs I— -� I --f TEDLAR <br /> I <br /> I <br /> Comments Security seals Ate,sent through Sac office Split samples on two different WO(STR04121060)because of differences in TAT <br /> i <br /> - - - - - Si ature_A — - <br /> Print Name -- �—LL ---I Company I Date/Time <br /> Received by —Law— - .� --Alpha Analytical,Inc 1,111j y <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(Sod) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-Liter V-Voa S Sod Jar O-Orbo T Tedlar B Brass P-Plastic OT Other <br />
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