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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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1267
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2900 - Site Mitigation Program
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PR0505602
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Last modified
6/20/2019 2:37:13 PM
Creation date
6/20/2019 1:37:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0505602
PE
2950
FACILITY_ID
FA0006891
FACILITY_NAME
BANK OF THE WEST
STREET_NUMBER
1267
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
11304217
CURRENT_STATUS
02
SITE_LOCATION
1267 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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LAS(LOCATION) Shell Oil Products Chain Of Custody Record <br /> 0 CAISCTNCE` ' Please Check Appropriate Box: Print Bill To Contact Name: INCIDENT# ENV SERVICES)) ❑O+Ea m No-Nabar*ARKIFS , <br /> ❑SPL f ' Q ENV.sFAVIGS } <br /> ❑ME14w; ' —, ❑MOTIVA RETAIL ����T�L Larry Silva 280943 9 7 0 9 3 4 1 9 DATE: <br /> Q MOTtVA S067H )✓CoesbL-'AN7 D LueEs PO # SAP# <br /> ❑� <br /> TEST AMERICA IRVNE 1 <br /> PAGE of <br /> ��( 1 ❑5T1I31 PIPELL4"c ❑onim 4 0 4 0 1 3 1 4 1 9]:771—L <br /> J wwvPen' ,.vw.• rta•Oeeea•,•.�.��r CAH amt A^�: <br /> Blaine Tech Services STSs 1267 Country Club Blvd,Stockton CA 70607700721 <br /> .xwasry oeurt,waa rom...<„..,..mn.�.,,w uo_ e.ru_ mkaetinwrr.zuer^.o_ <br /> 1680 Rogers Avenue,San.lose � ;rt�i- p <br /> r+a,Ecca.�.cr vr..w.•Dr e.e.�w Felicia Ballard,CRA,Sonoma 7D7.935-48SO sonomaedf reworkm co41) <br /> Lorin King avaen«,wcta Ir«o LAR USE ONLY <br /> ibV:Plr� IAl' Ex.Y, I <br /> 310.885-44„5 x 108 310.637.5802 IklnuAblainetech com <br /> TURNAROUNO TIME(CALENDAR DAYS). [:1 RESULTS NEEDM <br /> , DARD(t4 OAY) r'5 DAYS [D3 DAYS ❑2 DAYS CJ l'!OURs ON WEEKEND REQUESTED ANALYSIS <br /> AN <br /> '.A•RWQCB REPORT FORMAT uu:1ST AGENCY: <br /> sHeL CONrRA.rT RATE APPLIES TEMPERATURE ON RECEIPT C <br /> SPECIAL INSTRUCTIONS OR NOTES: <br /> u; ! _ <br /> 1)Please upload the"CRA EQuIS 4-file EDD"to the CRA Webstle ❑STATE RLIt16'JRSWE'NT RATE APPLE`S <br /> (ht(pWcraiab-d&-p,'oad.cSrwun'd co Wccws/defaultaspx)andtor send it to the Shell-US- EDO NOT NEEDED ,� ^ Y <br /> LabostamenagemenLj t@CRAworld.com email folder. 2) Please indicate that you have RE=vl3tnCATMKl REQUBTrM o a b ^ " <br /> uploaded the EDD by including"EDD Uploaded to CRA weoslte"m Jw body of the email ^ a I c - <br /> used to deliver the final PDF report to the Sthel:-US-LabOatat lwageme,.t@CRAvrorld.com a ,•`, V Q W I l �f I �Y t' rj �� <br /> ef <br /> mac o;der. <br /> Email invoice and Copy final report to Shell.Lab.Bilhng@craworfd corn TPHd Matrix Codes-WG(groundwater),Yds(surface O f $ o � c c <br /> reporting limit=<50 pg1L for GW San Joaquin Canty Requirernents watery,WP(drinWng water source),W(Trip or Temp w ° a <br /> SAMPLING <br /> e$ tJJ A-"Datln and Asers W EPA 8290 and Peaeddeby EPA e081A H PCP V Identrld Blnkl <br /> Field Sample Identification vm � <br /> 9 V <br /> OATS uAA1PLER Cpyr,W OF <br /> q Q x x x aE w 7 m L _ of q o CorrtalmrPlD Readings <br /> W IfG WtOJECT NUMBER (MMODIr INITIALS WELL ID TIME Sy Ru >•-� 3 O O Z t= U h'N Dos <br /> y_ = W W' � c e. or L.aborato V f <br /> IV �Ly. HCL NNOS'H1SW N°NE OTHER F 9 m W m W LL N 2 <br /> ° GW 1213 _ aP- s- i e to x 1 <br /> W <br /> W <br /> I <br /> 440-66281 Chan Of Custody <br /> i <br /> it <br /> I ' <br /> -i <br /> 5nenwanee ar Is gessel R•e.n+a h(sq"wl 0.a r�r. <br /> (6lcrry+) Do Ain: <br /> H• �.e oy:SlCrvsn; R.tM.e bf'�SiprY+.•) D.u. • J fins. <br /> C/o <br /> Ir4W Rwl41m <br /> O <br /> o <br /> .P <br />
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