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ARCHIVED REPORTS XR0001731
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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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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ARCHIVED REPORTS XR0001731
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Entry Properties
Last modified
6/20/2019 3:19:16 PM
Creation date
6/20/2019 1:51:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001731
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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SJGOV\wng
Tags
EHD - Public
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1 II II <br /> SHELL OIL COMPANY II CHAIN OF CUSTODY RECORD Dale. <br /> RETAIL ENVIRONMENTAL ENGINEERING - WE5T Sorlal No Page `.of <br /> SSS: II <br /> 1267 Country Club, Stockton, CA Analysis Required LAB: <br /> Wit 1: <br /> 204-7524-0204 <br /> �] CNICK ON[11110X ONLY Ci/o? TURN MOUND TkM1 <br /> Shell Englneor. Phone No . (510) IV I✓ G 4bnlar O"II <br /> ❑ "41 94*• . ❑ <br /> Karen Petryna 236-9139 :al <br /> M.lnr.Jl4db1 ❑ u"l ❑Fax Ia1 hoursConsullanl Name & Address; IBlaine Tech Services CW"VV/06 +al ❑ 4441 <br /> rs Wes flan Jose CA 95112 a0 rtaors ❑(NoirrwD <br /> 1680 X Wafer <br /> Consullanl Conlacl; Phon© Na , -- Ceuvrlur pa&a1 ❑ 4"3 11 ah.i ❑ <br /> Francis Thee 573-0555 (510) °; W/O lamas ' <br /> Qj FaM ui: <br /> x o m a o. If ❑I Nor[ N•IW lab as <br /> Commornls: [] n .o War•iI•moffyr loon orrorrlwocl <br /> N 'ter O&M ❑ t1�I 31141 Au rAr I <br /> 0 0 = u ac <br /> Sampled by. �� to o a o c °; olh.r ' II C1�- a o a. C v UST AGENCY: <br /> Prinled Name: .tL <br /> 0. u 0, 4 p N <br /> ° a ° II SAMPLE <br /> 0 0 <br /> Sample ID DalWalor Alr No of LisLi <br /> lac T ;� A E MATERIAL CONDITION <br /> p conk ,`L ^- 9a y ,a' U Q U U DESCRIIIfTION COMMENTS <br /> s II <br /> -- _ 0Z-,-3if-7- U1 <br /> S v — 11MMMAC10 N TiNTACT eT <br /> jx X CO XE TEM SRA 0R II or <br /> Rallnqulthed 8y(slgnalu Prinlad No DoleReceIV (SIC) r PlInlod Na ,-- I� Dale, / <br /> Relin ul Pllnled Name <br /> polo' / 0 dnnQ ujo <br /> Tlmo Il rims, <br /> Ralln shad By(slonolwa) Prinled Nome D( to N <br /> ' Rucuud I {Plum) Plinlod Names, I nils <br /> n V Lw ! <br /> E lb$QRdTQRY MUST PRQVIRE_,&C IYQEI111 11A1N_laF CU5rODY M jjL[ ICE ANp E5 II <br /> tis w <br /> x'1'1,el—e Z/14 1-1 3' c) <br />
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