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ARCHIVED REPORTS XR0003738
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 XR0003738
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Entry Properties
Last modified
6/21/2019 9:12:36 PM
Creation date
6/21/2019 4:35:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003738
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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SHELL OIL COMPANY CHAIN OF CUSTODYFORD CORD Do19:4K <br /> RETAIL ENVIRONMENTAL EUGINEERING - WEST Serial No: Page I of � <br /> Site Addreu: <br /> 2575 Country Club Blvd Stockton, CA �f Analysis Required LAB: <br /> WiCi: 204-7524-3505 CNE"0111 :to3l tirn�r Guar 1Lrm Amom nmi <br /> Shall Ertl lneer.. cw "GiabAme II ❑ X111 <br /> Phone No, 510 W hot" p <br /> Alec Perez FL��t7rr. 1GB s�o�Y..lbden j] w, <br /> �l�Aoxrr [� <br /> Con c fgnl N�mr & dd�ess- ' C&ALrrrokrorol D uu ❑,H � <br /> ec eu c <br /> acne res 10Cr�eu <br /> 1680 Rogers Ave San Jose GA 95112 XwMar <br /> ConstAlani Confacl, f'ho[�e Na., 408` 0 elwr�m4Pawl D 44" orua, <br /> I <br /> Fran Thi-e 573-0555 �; a ry wa�,otaw <br /> a e� 's <br /> a s m 1s2 <br /> Q 1 <br /> fax o NOTE No�/Lobal <br /> IC4�mmeRlS: a were l�at w i�,. Oban ar FJONL Dk4 LU <br /> Or <br /> o r Li d lir/a h= TAL <br /> W1 x '13 <br /> I <br /> SUMplad by: o o _ N z ores r ❑ <br /> m <br /> o �► UST AGENCY: <br /> Prmlatl We: G�.c � w LU `o n u Cm b ° SAMPLE <br /> D n Q <br /> Flo.at o a c m E MCRIPATERIAJ <br /> IOI CONDMONJ <br /> 5arinplQ ID Dole strldga soli woiar AirCL <br /> m .- is oIrSGRIPTIoIN <br /> cony �- $_ no y r U d a. V COMMENTS <br /> C - <br /> RaAnglfdnW11yaluffil <br /> . Prinled Ha Do� . Waco ( Plinied Na" Qala_ <br /> ime -z_ i�'4`f <br /> >tQllnq Prinied Normo. Data 1[ Rac tvod (slonniura) hinted Nall. Date; . <br /> Dyne. 1� a, <br /> Ralinglfiteed ey!sl�nlurel Printed Name Do[* Raced fOgnolura) Pdniad ijanoa. Dalo , <br /> TTn14111 <br /> 11DI A QG PYO it <br />
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