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ARCHIVED REPORTS XR0005961
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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2081
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3500 - Local Oversight Program
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PR0544590
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ARCHIVED REPORTS XR0005961
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Entry Properties
Last modified
6/21/2019 2:50:39 PM
Creation date
6/21/2019 11:04:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005961
RECORD_ID
PR0544590
PE
3528
FACILITY_ID
FA0003932
FACILITY_NAME
KWIKEE FOODS
STREET_NUMBER
2081
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12315225
CURRENT_STATUS
02
SITE_LOCATION
2081 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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j�D&OUOiA ANALYTICAL LJ 819 Striker Avite 8 a Sacramento, CA 95834 0 (916) 921-9600 FAX (916) 921-,* <br /> U 404 N.Wiget L •Walnut Creek, CA 94598 - (925) 988-9600 FAX (925) 988-961 <br /> %V CHAIN OF CUSTODY U 1455 McDowell Blvd. North, Suite D a Petaluma, CA 94954 a (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road a San Carlos, CA 94070 0 (650) 232-9600 FAX (650) 232-9612 <br /> Company Name: ti V 'u - Ile— 4�(o Project Name: 60 L l � <br /> Mailing Address: - 36 Billing Address (if different): <br /> City: ^� 5 State: Zip Code: _�z 5 2— <br /> Telephone: <br /> — <br /> Tele hone: FAX #: P.O. #; <br /> Report To: ��. {'�� �rte-- Sampler: �t,,,� QC Data: evel D (Standard) 0 Level C U Level B U Level A U <br /> Y <br /> Turnaround IX-10 Working Days U 3 Working Days J 2- 8 Hours U Drinking Water Analyses Requested i%_ <br /> Time: J 7 Working Days Q 2 Working Days U Waste Water <br /> U 5 Working Days U 24 Hours U 01her <br /> Client Date/Time Matrix #of Cont. Sequoia's Comments <br /> Sample 1.D. Sampled Desc. Cont. Type Sample # <br /> 2 <br /> rn <br /> 3. <br /> 4. <br /> 5. <br /> 6. <br /> -- <br /> 8, <br /> 9. �- <br /> 10. <br /> Relinquished By: t L L. Date:2 f� r Time: i 7X) Received B 7 � <br /> -- - - — �� L) Time: t <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Heliriquished By: Date: Time: Received By: Date: Time: <br /> Wejo_ S imples Received in Good Condition? U Yes U No Samples on ice? J Yes U No Method of Shipment Page of <br />
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