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ARCHIVED REPORTS XR0006565
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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1403
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2900 - Site Mitigation Program
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PR0505513
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ARCHIVED REPORTS XR0006565
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Entry Properties
Last modified
6/21/2019 9:35:11 AM
Creation date
6/21/2019 9:00:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006565
RECORD_ID
PR0505513
PE
2950
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
02
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
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EHD - Public
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B.P. OIL COMPANY N2 0169ioce,. - <br /> 16400 Southcenter Parkway, Suite 301, Tukwila, WA 98188 <br /> PNCORPORAT F C CHAIN OF CUSTODY <br /> THE ASSURANCE OF OUAEITY <br /> Novato, CA, 11 Digital Drive, 94949 ❑ Huntington Beach, CA, 5702 Balsa Avenue, 92644 <br /> Phone: 415 883-6100 Fax: 415 883-2673 Phone: 714 892-2565 Fax: 714 8904032 <br /> Consultant's Name: 1'�C Consultant Project#: 0 <br /> e Pae of <br /> Address: A,'11. <br /> ��1j U N C td `� <br /> Project Contact: 1� <br /> /7 1� owa � Phone#: 2} S' 1p Fax#: Consultant Work Order#: <br /> Sampled by (print): r (/ t Sampler's Signature: B.P. Site Location#: <br /> Shipment Method: C Airbill #: Shipme <br /> � nt Date _ B . Site Location: Jo <br /> ANALYSIS REQUIRED Sample Condition as Received <br /> TAT: El 24 hr ❑ 48 hr ❑ 72 hr Standard(10 day) Temperature' C: <br /> Cooler#: <br /> H © Inbound Seal Yes No <br /> j ca m Outbound Seal Yes No <br /> 00 <br /> j 00 <br /> Sample Description Collection Matrix Prsv #of PACE C7 0�o C] ago x ct U <br /> DatePlime SoiVWater Cont Sample# a a a a > - COMMENTS <br /> H W 1~ W E� fii x oQo <br /> i <br /> C - S qF5� <br /> C - 1350 MWI� 3 - <br /> Relinquished b Affiliation Date Time Accepted by/A( liation Date Time Additional Comments: <br /> 0o3 <br /> 4 <br /> �Ij <br /> n;, 1.,,,; lf? -^ a=F.;.• r�,;,.;, l Vf,llmv 11P nil Pink-I.ah Goldenrod-Consultant Field Cra1T <br />
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