My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0013038
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
L
>
LODI
>
2500
>
3500 - Local Oversight Program
>
PR0545420
>
ARCHIVED REPORTS_XR0013038
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/5/2020 6:31:45 PM
Creation date
3/5/2020 4:59:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0013038
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
67
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Alpha Analytical, Inc. <br /> i Phone:(775)355-11044 ' FAX:(775)355-0406 <br /> Sample Receipt Checklist <br /> I Date Report qs due to Client: 3112/2004 Date of Notice: 3/512004 9:20:33 A <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 Project ID: 2007-0065-011 USA 65 <br /> 4 <br /> Project Manager: Gowri Kowtha Client's Phone (530)676-6002 Client's FAX (530) 676-6005 <br /> Work Order Number STR04030522 Date Received: 3/5/2004 Received by: Graciela Navarrete { <br /> i <br /> Chain of Custody(COC) Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes ❑ No <br /> Custody seals intact on shippping containedcocler? Yes ❑ No Not Present ❑ <br /> II Custody;seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> i <br /> Chain of custody signed when relinquished and received? Yes 0 ❑ No l <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> , <br /> Sample ID noted by Client on COC? Yes (] ❑ No t <br /> Dale and time of collection noted by Client on COC? Yes ❑ No <br /> Samp lers's name noted on COC? Yes ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ d❑ No f <br /> Sub Contract Lab Used: None SEM Other see comments ❑ <br /> Sample Receipt information <br />` Shipping container/coder in good condition? Yes ❑ ❑ No Not Present ❑ <br /> Samples in proper containertbottle? Yes 0 ; ❑ No f <br /> Sample containers intact? Yes ❑ No <br /> tSufficient sample volume for indicated test? Yes 7V El No <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes 0 ❑ No Cooler Temperature <br /> Container(Temp Blank temperature in compliance(0-6'C)? Yes +❑ ❑ No 40C I <br /> Water-VOA vials have zero heads pace 1 no bubbles? Yes El El No Na VOA vials submitted 0 <br /> Sample labels checked for correct preservation? Yes No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA ❑ i <br /> Analytical Requirement Information <br /> Iki <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are these client specific Project requirements? Yes ❑ 0 No If YES :see the Chain of Custody(COC) <br /> - 1 <br /> Comments <br /> F � <br /> II <br /> I <br /> .l <br /> ' i <br />
The URL can be used to link to this page
Your browser does not support the video tag.