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ARCHIVED REPORTS XR0005964
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 XR0005964
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Entry Properties
Last modified
6/21/2019 2:13:19 PM
Creation date
6/21/2019 11:07:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005964
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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u UU:J Jai Vla UI rowryan rliu, UA VbWl • (4U8) 776-9600 • FAX (408) 782-6308 <br /> EQUOIA ANALYTICAL U 4Q4 Ntrwiget Lane Oite 8 o Creme to 459883925988 961 9600 FAX (916) 9200 <br /> ( ) 00 FAX (925) 988-9673 <br /> (OCHAIN OF CUSTODY U 1455 McDowell Blvd. North, Suite D e Petaluma, CA 94954 o (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road o San Carlos, CA 94070 a (650) 232-9600 FAX (650) 232-9612 <br /> Company Name: <br /> y Name: Project N <br /> 4 C ILL{ L�.L✓4 J 1,i�Lv v L.L"t LL <br /> Mailing Address: -556 ALS LsTe, [ C Billing Address (if different): <br /> City" I ! (�� <br /> State: <br /> i� 0,_ Zip Code: <br /> Telephone- l _ <br /> -S L-•4E FAX #: P.O. #: <br /> ` w <br /> Report To: 4 . t'�a v � — Sampler: L u� QC Data: aLevel D (Standard) U Level C © Level B Q Level A Q <br /> Turnaround>43 10 Working Days 0 3 Working flays ❑2 -8 Hours U Drinking Water Analyses Requested Y <br /> c <br /> Time: ❑ 7 Working Days ❑2 Working Days U Waste Water <br /> a- <br /> U 5 Working Days ❑24 Hours D Other <br /> Client Date/Time Matrix # of Cont. Sequoia's ! <br /> Sample I.D. Sampled Desc. Cont. Type Sample # � Comments <br /> " <br /> 13 LJ <br /> 2. f~'F <br /> Cr <br /> m <br /> 3. <br /> 3 0 <br /> 0 <br /> 4. r m <br /> It <br /> 5. �41r <br /> s. Mt' _ <br /> 7. <br /> •o <br /> w <br /> 07 <br /> 9. ai <br /> 10. <br /> Relinquished By: �r 1 L. at j,__•. --- Date: % I i Time:,'> Received By, <br /> ' fl3�te�: Time: JJJa5 <br /> i <br /> Relinquished By; — -- � — - Date: -- Tirne: Received By: Date: Time.- <br /> Relinquished <br /> ime:Relinquished By: _ Date: Time: Received By: Date: Time: <br /> 4�h;r S iinrl.rs Fif;ceivt ii lir (aoc;r! Corirlitir;ii'1 `l`fes _I hfu Sar"}ales utt lciP !Ye,, i..1 No Method of Shipment pare e1 <br />
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