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ARCHIVED REPORTS XR0003533
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 XR0003533
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Last modified
6/21/2019 8:29:56 PM
Creation date
6/21/2019 3:56:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003533
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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EHD - Public
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COOLER RECEIPT FORM <br /> t r— ' Log No <br /> receive an- ,� a c ec e by 1_ S,r-� nS�.-� <br /> .y <br /> na ure <br /> e custody papers present' . . YES -)NO <br /> e custody papers properly filled out' . . AYES NO <br /> e the custody papers signed' . . . . . . . . . . . . - -YY'S) NO <br /> sufficient ice used . . . . . . . . . . . . . . . . . . . . . . . AYES) NO 6�� <br /> all bottles arrive in good condition (unbroken) ' . . -Y`S NO <br /> bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . .yS NO <br /> e proper bottles used for analysis indicated-;' . . . . . . .. ES} NO <br /> rect preservatives used . . . . . . Q.YE) NO <br /> vials checked for headspace bubbles? YE5 NO <br /> Note which voas ( if any) had bubbles . * <br /> iple descriptor Number of vials : <br /> 1 oAs with headspace bubbles have been set aside so they will not be <br />,ea for analysis . . . . . . . . YES NO <br />.t here all other fobs received in the same cooler: <br /> ent Job # NET log # <br /> (coolerrec) <br />
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