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ARCHIVED REPORTS XR0005966
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 XR0005966
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Entry Properties
Last modified
6/21/2019 2:12:54 PM
Creation date
6/21/2019 11:10:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005966
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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im- SEQUOIA ANALYTICAL El 680Apeake Drive• Redwood City, CA 94063• (650) 364-9600 FAX ( 3 <br /> VW 0 819 Striker Ave., Suite 8•Sacramento, CA 95834• (916)921-9600 FAX (916) 921-0100 <br /> CHAIN OF CUSTODY ❑404 N.Wiget Lane• Walnut Creek, CA 94598• (510)988-9600 FAX (510) • <br /> ( ) 988-9673 <br /> Company Name: P!qrR t Project Name: L <br /> I V M t�td. <br /> Address: �O <br /> Billing Address (if different): <br /> City; SrDgr(bj State: CA- Zip Code: <br /> Telephone: 20q �� Z ' ?.d FAX#: S� P.O. #: «. <br /> Report To: .0 <br /> a� <br /> One-44c.o�. — Sampler: , OC Data: Level D (Standard) ©Level C 0 Level B ❑ Level A v <br /> Turnaround Working Days U 3 Working Days p 2-8 Hours ❑Drinking Water <br /> r 9 Analyses Requested � <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water 0- <br /> El <br /> ❑ 5 Working Days ❑24 Hours U Other <br /> Client Date/Time Matrix #of Cont. Sequoia's <br /> Sample I.D. Sampled Desc, Cont. Type Sample# Comments <br /> 1. <br /> KF- 1 1111 .Z k vJ <br /> 2. KF -z 2, q5 Cr <br /> KF- <br /> 3. - <br /> 4. } <br /> 5.6. , <br /> ' { <br /> . <br /> Lj1 <br /> J.- <br /> 0 <br /> 8. ti Cr <br /> Q <br /> 9. <br /> {r <br /> 10. <br /> Relinquished By: <br /> Date: ( c Time: J Z;uo Received By: j Date: z { Time: L"la, <br /> Relinquished By; Date:t Time:Z-' Received By: <br /> Y Date: Time: <br /> Relinquished By: Date: Time: Received By L ,/ <br /> l7 Dated z`t Time: 30 <br /> Were Samples Received in Good Condition? ! Yes 0 No Samples on Ice? gYes U No Moth d of Ship ent Paae of <br />
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