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ARCHIVED REPORTS XR0000652
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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3128
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3500 - Local Oversight Program
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PR0544112
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ARCHIVED REPORTS XR0000652
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Entry Properties
Last modified
2/7/2019 5:25:12 PM
Creation date
2/7/2019 3:35:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000652
RECORD_ID
PR0544112
PE
3528
FACILITY_ID
FA0005145
FACILITY_NAME
EXXON COMPANY USA
STREET_NUMBER
3128
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09523002
CURRENT_STATUS
02
SITE_LOCATION
3128 W BENJAMIN HOLT DR
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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li <br /> RINCO <br /> f* ace <br /> EXXON COMPANY, U.S.A.P O Box 4415 Houston TX 77210-4415 <br /> APORATta � CHAIN OF CUSTODY <br /> ASSI1flANCE OF OltA L17Y � <br /> Consultant Name p 1 ti/ r'tsr7 f <br /> Novato, CA Address too <br /> �► 11 Digital Drive,94949 Project Contact i I►t C.0 S Pro ect# f -ta[) <br /> (415)883-6100 Phone# S `3 V[5 G Fax# �Z / 5—?>9) -CY Z0 <br /> ❑ irvine, CA Consultant Work Release# <br /> Alton Business Park <br /> 30 Hughes St , Suite 206,92718 Exxon contact '7P Phone# <br /> (714)380-9559 Site RAS# <br /> Site Location lk/- Vto I+Or- t-c> C'4 <br /> Laboratory Work Release# / <br /> pled by(please pant) SOIL WATER I19 Y7rn () <br /> S ler ignatu Datepled W W `�� N �r ot•i <br /> � 3 V � <br /> co --o <br /> Sample Collection #of $ o o _ o Remarks <br /> Description Date/Time Matrix Prsv Cont a s a s = a a s <br /> Hw �w Oo F-w Hw Oo <br /> tel! i <br /> -10A <br /> ��� ° Relinquished by/A#Illatlon Accepted by/Afilhatlon l Date Time <br /> Cooler Seal O <br /> Intact <br /> Yes <br /> Q <br /> ❑ No t� <br /> Turnaround Time <br /> (circle choice) <br /> N <br /> 24 hr <br /> 48 hr <br /> 72 hr <br /> r <br /> 5 wo?itti�y-�. <br /> (sta <br /> ipment Method Additional Comments - "-�- p ? ,�_ i to <br /> Shipment Date <br /> Distribution White-Original Yellow-Exxon Pink-Lab Goldenrod-Consultant Ficid Staff <br />
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