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ARCHIVED REPORTS XR0003487
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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2575
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2900 - Site Mitigation Program
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PR0541989
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ARCHIVED REPORTS XR0003487
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Entry Properties
Last modified
6/21/2019 9:52:40 PM
Creation date
6/21/2019 3:44:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003487
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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5N 1. Chain Of Custody Record �z,7og Ak <br /> Lob Y) Equina Project Manager to be Invoiced. 1W 34-w'-9 � , <br /> Atldreu <br /> ❑ <br /> City.City. 4a Karen Petryna 9 8 9 9 6 1 8 4 nAr� 3 <br /> s,a�e <br /> [J p � PAGE �12 of <br /> ccMwANv Loo ADDRESS MUM wid cryp No_ <br /> Blaine Tech Services BTSR 2575 Country Club Stockton T0607700697 <br /> ew 0FUVVV4U M awwwwwftb waw~ R104E NO E�IAL CONf11,TANT PN01 NO <br /> 1660 Rogers Avenue,San Jose,CA 95112 C30 <br /> PF"CT CWTACT¢W�-; or NP Raw*k Joe Nse 707•433a3B1 sonornaed camrn bria-mv coSTSs <br /> Leon Gearhart NAifisllwwr � <br /> TGrc RAX <br /> 408-U3-0 555 406.573-7771 Igearhart[�bleirTe, corn '�/�`(� <br /> TURNAROUND TIME(BUSINESS DAYS): <br /> 10 DAYS ❑ S DAYS❑ n HOURS❑ 48 HOURS ❑ 24 HOURS❑ LESS THAN 24 HOUItS REQUESTED ANALYSIS <br /> I <br /> ❑ LA RWQCB REPORT FORMAT ❑ UST AGENCY <br /> GCUSLiTBECONFIRMATIDN HIGHEST HIGHESTper0ORwG ALL FIELD NOTES- <br /> SPECIAL INSTRUCTIONS OR NOTES CHECK BOX IF EDD ISMI NEEDED <br /> GontainerlPreservetive <br /> �0. or PID Readings <br /> gor Laboratory Notes <br /> V o o » m m <br /> Field Sample Identification SMPLING AfATRMMM OF C TEMPERATURE ON RECEIPT C' <br /> W4L1' DATE TIME <br /> !�Izp3 r l <br /> 1 <br /> wo <br /> r <br /> r/ <br /> / x ' X <br /> /o �( x <br /> y <br /> 100 <br /> r <br />� t <br /> N <br /> ZD <br /> j I R.�w.d by tsanfYlrq <br /> hr[ ■iR.c.inahr ts�+r.► o+er Thew <br /> RrMp�INAbY[S ) R06044d by(5Wmknl � OR* Tim r)` /70& 8 <br /> DISTR(B IIM WHIT wNh ILMI r%=%GrM b Flu Yflpw VW Pb*bcienL IWOM RewWw <br />
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