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ARCHIVED REPORTS XR0006593
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 XR0006593
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Entry Properties
Last modified
6/21/2019 9:42:02 AM
Creation date
6/21/2019 9:05:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006593
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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EHD - Public
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114 VV4; i VJ _ - " " •., •,�,yu�I I Im. L^ 0,)VOr twv8 /I0-U0UU - i-Hx 41..18 782-6308 <br /> ❑819 Striker Ave ,Wainut <br /> 8 - Sacramento, CA 95834 - (916) 921-9600 FAX (916) 921-0 <br /> i 404 N Wiget La Creek, CA 94598 - (925) 968-9600 FAX (925) 988-9673 <br /> 10 <br /> TOSCO ❑ 1455 McDowell Blvd North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road-San Carlos, CA 94070 - (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company ,N C Project Name l qo 3 <br /> Address s C� , U TOSCO Engineer(required) r <br /> :City 'r,;.�, State Zip Code �- <br /> i <br /> Telephone qyFAX # <br /> �j � /-78'� Site #, City, State �`f Z 5 N [ <br /> Report Toqa.%� Sampler � a�gG� QC Data ALevel D (standard) ❑ Level C ❑ Level B ❑ Level A U <br /> Turnaround A0 Work Days ❑5 Work Days ❑3 Work Days ❑ Drinking Water Analyses Requested C <br /> Time ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours ii <br /> 0 Waste Water <br /> CODE: ©Mise ❑Detect ❑ Eval ❑Remed ❑ Demol ❑Closure Other ��� �o� <br /> - <br /> Client <br /> te[Time Matrix # of <br /> Sample I D Sampled Desc Cont Cont Sequoia's ��QP� ��`����\P�'° `P4P�h�� �va��` Comments <br /> Ype Sample # �Q �� �� �Q� �o� ��� <br /> 1 - 1426 ffy0 5 VO4 oIA —E X <br /> 21Aw I 2b �f DNo <br /> � <br /> X Cr <br /> 3 a) <br /> U) <br /> 4 <br /> 0 <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 Q <br /> po <br /> +� <br /> m <br /> Relinquished B Date 1`a ,tp Time Received By Date / z Time <br /> a� <br /> Relinquished By Date / Time/(>`fin Received By ate Time <br /> Relinquished By Date Time Received By Date Time <br /> I <br /> Were Samples Received in Good Condition? ❑Yes ❑ No Samples on Ice? ❑Yes ❑No Method of Shipment Page e_of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported9 ❑Yes ❑ No If no, what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />
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