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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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Tags
EHD - Public
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u III jarvis Ur - Morgan Hill, CA 95037- (408) 776-9600 - FAX (408) 782-6308 <br /> 41*EQUOIA ANALYTICAL ❑ 819 Striker 2sWe 8 ® Sacramento, CA 95834 - (916) 921-9600 FAX (916) 9200 <br /> Ll 404 N.Wiget Lanes Walnut Creek, CA 94598 - (925) 988-9600 FAX (925) 988-9673 <br /> W/ CHAIN OF CUSTODY ❑ 1455 McDowell Blvd. North, Suite D , Petaluma, CA 94954 0 (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road - San Carlos, CA 94070 0 (650) 232-9600 FAX (650) 232-9612 <br /> Company Name: <br /> AlieJ Project Name: ?TJ5 <br /> Mailing Address: I <br /> 3 u5 C c:�� Billing Address (if different): <br /> : <br /> Cit ! <br /> City: U w Sta e: cf4 zip Code:is z S Z <br /> Telephone: -17 2 -36 2-o FA #: P.O. #: 2 ov0 j,q <br /> C <br /> Report To: ,C- t'7� Sampler. ` i: <br /> QC Data: �evel D (Standard) 0 Level C ❑ Level B U Leve! A <br /> Turnaround KtO Working Days ❑3 Working Days Q 2-8 Hours U Drinkin Water <br /> Y <br /> 9 Analyses Requested � <br /> Time: U 7 Working Days U 2 Working Days U Waste Water o_ <br /> © 5 Working Days ❑24 Hours <br /> ❑Other <br /> Client Date/Time Matrix # of Cont. Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample # �e (� Comments <br /> c� Ca <br /> 2. � �-� !ti {�a�. o <br /> C <br /> Cr <br /> m <br /> 3. rn <br /> 0 <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> c� <br /> 0 <br /> 8. Cr <br /> (D <br /> v7 <br /> 9. <br /> a) <br /> 10. <br /> Relinquished By: t, D�/000Time: �7r0 Received By: U 2K Kvc�?�)�J)ate-1Time: <br /> _��� "` <br /> %i*'1�' <br /> Relinquished By: Date: Time: Received By. Date: Time; <br /> Relinquished By: Date: Time: Received B �- — - <br /> Y' Date: Time: <br /> Were Samples Received in Good Condition? U Yes U No Samples on ice? U Yes U No Method of Shipment_ _ _ Pae of <br /> 9 <br />
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