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ARCHIVED REPORTS XR0000316
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BENJAMIN HOLT
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2905
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3500 - Local Oversight Program
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PR0544110
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ARCHIVED REPORTS XR0000316
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Entry Properties
Last modified
2/6/2019 4:57:28 PM
Creation date
2/6/2019 4:53:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000316
RECORD_ID
PR0544110
PE
3528
FACILITY_ID
FA0003712
FACILITY_NAME
CHEVRON STATION #94275*
STREET_NUMBER
2905
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09760004
CURRENT_STATUS
02
SITE_LOCATION
2905 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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WNg
Tags
EHD - Public
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i ux (,Upk of LOD Keport ane LU(, to Chevron Co ct: ❑ No Chain—of -- cuSt —Record <br /> Chevron Focilily Number74215 Chevron Contact (Name) 11 e L C 11 u n C e r <br /> Foopity Address 2905 W Benjamin dolt Dr _, Stockton (Phone) (510) 842-8695 <br /> Ghavron U.S.A. Inc. ' <br /> Consultant Project Number <br /> P.O. BOX 5004 Laboratory Name C;'1'T+'T. <br /> Coneultonl Name Maine TechServt.ces, Cnc <br /> San Ramon, CA 94583 85 Timothy uwthy C)x . , San Jost , {;A 95133 Laboratory Release Number 3532830 <br /> Mires• .rr � <br /> FAX (415)842-9591 Samples Collected by (Nemo) <br /> Proleci Conlan (Name) Jim Keller Collection DDate�� <br /> (Phonejrl08 99 5.-5535—(Fax Number)iiQB—Z9-3-81-7-3—. SIgnaIur--, <br /> Analyses To Be Performed <br /> q DO NOT BILA. <br /> TOR TB-LB <br /> o° <br /> l R O t711 d F °-� ti-. n,-. �.'I <br /> �3 n ?. �a o'er cr"'' ro �ry VJ cn 0- <br /> 06 o <br /> o ry p Vv a <br /> E p > 1 F e w u� "� dui Lrnu ;�ami `l <br /> f o { <br /> 5 z war r a- `� I o a." A. d'`- 1: czi <br /> Remarks <br /> Mw-1 --01 3 W 13i5 � Y X i <br /> — <br /> Nt�,-`{ - <br /> 11r1w-5 L)S 3 12-40 _ ;K <br /> 1Ylw-6 <br /> �o <br /> Mw_g Off 3 ++ 17. 0 x <br /> Mw-'1 b°� 3 lZla A <br /> 1 a o� <br /> 702 651 5871 <br /> a loqulshod (Slgnoture) Organi:allon Dote mo R III BY (SIGH tura) OrgonlxalIon Da s/T1me� Turn Around Time (Circle Choice) <br /> � 0 L � � 24 Hn. <br /> Y <br /> Relinquished By (Signature) or anlzatlon Doefllme f�'IQ Rocolvod Dy (Signature) orgonlxotlon Data/,nme 48 Nn. <br /> n 1i [� 3'ZZ- -16 6 a <br /> 10 Days <br /> Rellnqulehed BY (Signature) Organlxation Date/time R+ ed For Laboratory Py (Signator+) Date/'llme As Contracted <br /> a <br />
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