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ARCHIVED REPORTS XR0000355
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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 XR0000355
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Entry Properties
Last modified
2/7/2019 9:45:27 AM
Creation date
2/7/2019 8:19:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000355
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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.r-4k %—oNy v, L—uu ,\t:;Pui t. uiiu uut, to t.,ncvron uonL ( U NO 1-29-0111y) Chain - Of—Cusfo --Record <br /> Chevron Fw1lity Number —4275 qw Chevron Contact (Noma) Brett Hunter <br /> Ch6Yr0r3 U.S.A. Inc. <br /> Foollity Addroee 2905 W. Benjamin Holt Dr , Stockton (Phone) (510) 842-8695 <br /> — G/ <br /> P.O. BOX 5004 Consultant Project Number laboratory Name_— fiPnil:LHa_ <br /> Consultant Name Blaine Tech Services. Inc - -- <br /> Sari Ramon, CA 94583 Laboratory Roloaea Number 903019 <br /> 1680 Ro ers Ave. , San Jose, CA 95112 Sarnpios Coflocted by (Noma) /`fi <br /> FAX (415)842-9591 Address r a <br /> Gruel e <br /> Project Contact (Noma) Fi:an Thze <br /> Copaallon Data <br /> y (phone)408-573-0555 (Fax tlumbor)408-573-7771 Signature <br /> S Malysoo To tie Porformod <br /> {{d ti p DO NOT BILL <br /> �U <br /> FOR TB-LB <br /> [ <br /> r o Q V o o r <br /> r3.� ,tl 0M <br /> VI ,�j VI p fl xx O O`. r fV� N �l O n a V�1 <br /> J 7 � ` E a I1'f Y ra a.f�r1f aOj ep �a <br /> n Ramarke <br /> od /TG t <br /> FF <br /> _ p3 <br /> -5 OC <br /> 2 x x <br /> li <br /> Rai ln h Ily (Slgnolurs Organization Da e/limo Re ad t1y re Or anI lion <br /> T� Data/T1mo�Fs Tum Around Time (Circle Choloo) <br /> 24 Kra. <br /> qu sd Dy 7 10 <br /> SI re) organlzatlon Date/nrne Rocolvad By (SE rq n io an Dale me 46 Kra. <br /> i/z�� <br /> 5 Gaya <br /> rRatinquishod Eiy (Signature) Organization Dale/'timo flecloved for LaboratorySI nu10 Days <br /> D y ('gturo} D to/ftMe <br /> Aa Cantrvoted <br /> 12 <br />
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