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ARCHIVED REPORTS_XR0003855
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_XR0003855
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Entry Properties
Last modified
3/5/2020 6:02:19 PM
Creation date
3/5/2020 4:37:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003855
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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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 1013112003 Date of Notice 1012312003 10 11 45 <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 Protect ID 2007 00651USA 65 <br /> Protect Manager Gown Kowtha Client's Phone (530) 676-6002 Clients FAX (530)676-6005 <br /> Work order Number STR03102342 Date Received 10/23/2003 Received by Dolly S Baker <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Chain of custody present ? Yes �1/1 I_ No <br /> Custody seals intact on shippping containericooler 7 Yes 116 No Not Presen i <br /> Custody seals intact on sample bottles? Yes .1 L No Not Presen <br /> Cham of custody signed when relinquished and received ? Yes J No <br /> Chain of custody agrees with sample labels? Yes rl�l ❑ No <br /> Internal Chain of Custody(COC)requested? Yes r Vi No <br /> Sub Contract Lab Used None ] J SEM Other(see comments) U <br /> Sample Receipt Information <br /> •Shipping containerlcooler in good condition? Yes �1 J No Not Presen IJ <br /> samples in proper container/bottle? Yes lvj J No <br /> Sample containers intact? Yes ,vd i__I No <br /> Sufficient sample volume for indicated test? Yes a✓ No <br /> Sample Preservation and Hold Time HT Information <br /> All samples received within holding time? Yes Yn 17 No <br /> Cooler Temperature <br /> Container/Temp Biank temperature in compliance(0-6°C)? Yes iii 17 No NA°C <br /> Water-VOA vials have zero headspace I no bubbles? YesI J` I No No VOA vials submitted V <br /> TOC Water-pH acceptable upon receipt? Yes I_J No NIA '�i <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes [J No <br /> Are there client specific Protect requirements? Yes ❑ W No If YES see the Chain of Custody(COC) <br /> Comments <br />
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