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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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L
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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_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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r •l <br /> Billing lnfonnaUon ' <br /> CHAIN-OF-CUSTODY RECORDCA Page <br /> loft <br /> Alpha Analyical, Inc. � orO> d <br /> > STR031 l 044 l <br /> I 255 Glendale Avenue,Suite 21 SparLs,Nevada 89431-5778 <br /> Client FEE, (775)355-1044 rAX (775)355 0406 Repoi f Due By 5 00 PAI Oil. 12-Nov-03 <br /> Stratus Environmental ij Gown Kowtha <br /> 3330 Cameron Park Drive TEL (530)676-6002 <br /> Suite 550 FAX (530)676-6005 EDD Regiurecl Yes <br /> Cameron Park CA 95682-8861 I} Job USA 65 Sampled by C I till <br /> Report Attention Gown Kowtha; PO Client's COC# 2429 Cooler TemI NA °C <br /> CC Report i 04-Noy'-03 <br /> QC Level S3 = Final Rpt MBLK LCS MS/MSD Willi Surrogates <br /> 1� <br /> Alpha Client I° Collection No of Bottles TPI{/P-A voc_n Requested 1 Tests <br /> D l <br /> Sampe ISample ID Matrix Dale ORG SUB TAT PWS It I <br /> _ _ � I r <br /> _ _ ✓ ✓ I Sample Remarks <br /> STR03110441-01A INF Air I AR 11/03/03 1 --- 0 6 BIXUCCAS e7xFJGAs —- �— -� �--- -- _ - - <br /> �T d 0600 f 05axy5 ClSoxye I Tedtar bag <br /> STR03110441-02AI MID Air AR 11/03/03 i 1 0 6 urxUoAs BIxrroAs- _ Tedlar bag <br /> 11 05 513 1 C/Soxys G5oxys <br /> STR031104g1-03iI 6�FAr ircxrsEa,rxya.s_ n�xrlcns_ i� i - — i TedlarbaJ0556 1 <br /> I" <br /> 1 <br /> h" <br /> I� <br /> I� <br /> li <br /> li <br /> U <br /> f <br /> i <br /> Cnrumeuts Cirslocy sea] Na+cc nec,ded CA saneples Send cony of recw>LI cltecklist%vid,final iepoit <br /> r <br /> it Sign rturc t'r fill glare Cnni w+ <br /> I Y Drtefl+rite <br /> Alph i An ilk tic d,Inc <br /> NOTE Samples are discarded 60 days after results are reported unless oilier arrangemenls are made Hazardous samples will be rehimed 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 tills COC The IrabiMy of the laboratory r5 11mlled t0 111e amount patd for rile report <br /> Matrix Type AQ(Aqueous) AR(Air) SO(Soil) WS(Waste) DW(Drinking Water) OT(Other) Bottle Type L-titer V-Voa S Sod Jar 0 Orbo T-Tedlar B-Brass P-Plaslfc OT-0ther <br /> Ii <br /> R <br /> b <br /> " <br />
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