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ARCHIVED REPORTS XR0000657
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 XR0000657
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Entry Properties
Last modified
2/7/2019 5:49:43 PM
Creation date
2/7/2019 3:38:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000657
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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o-; <br /> EXXON COMPANY, U.S.A. <br /> PO Box 44 t5 Houston TX 77210 4415 <br /> AI_q <br /> O R P t) R A 1 E 0 <br /> CHAIN OF CUSTODY <br /> rMl ISSpgagil Or Ouair Er-- <br /> _Consultant Name t�51 ti/•r aY+fr► ��CVI 5� `' - <br /> Novato,CA Address tp mar-A-7c- 14u.,j - <br /> 11 Digrtai Drive 94949 ___Na Contact J M 'S 4 #4 u'1263 Pro ct* f'Of-� <br /> (415)883-6300 Phone* L4 f .5 - 2, r .. Fax* 4!5- 3L'-" it'1-t Z 3 <br /> ❑ irvine,CA Consultant Work Release* <br /> Alton Business Park <br /> 30 Hughes St ,Suite 206 92718 Exxon Contac63� � a 17 Phone* f 5`" Z`tt JK7� <br /> (714)380-9559 Site PAS* -'- U <br /> Site Location 3, -2-% Y"O f�5 i.1 <br /> Laboratory worts Release* ! ! <br /> --- - <br /> S8am y leaserent) SOIL. WATER <br /> 2- /+-JAS 5 <br /> Sampler Signature Date S=Plod W <br /> Sample U Collection *of a i $ Remarks <br /> Description DateifTime Matrix Prsv Cont �W k W d� !z W 11 W d� �W <br /> G Z s k` <br /> Cooler <br /> S � <br /> No Relinquished by/Affiliation Accepted by/Affiliation Date Time <br /> Cooler Seal <br /> Intact <br /> • �' Yes Z 9j�1f <br /> a a� <br /> + No r-- <br /> Turnaround Time } <br /> ' (circle choice) 1 ` <br /> 48 hr <br /> 72 hr <br /> 96 hr ( r <br /> r 5 workday V <br /> (star►dard) <br /> Shipment Method Additional Comments <br /> Shipment Date <br /> Dtsinbution White Onginal Yellow Exxon Pink-Lab Goldenrod-Consultant Field Stats <br />
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