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ARCHIVED REPORTS XR0003739
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 XR0003739
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Entry Properties
Last modified
6/21/2019 10:00:22 PM
Creation date
6/21/2019 4:36:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003739
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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1 <br /> •HELL OIL COMPANY CHAIN OF CUSTODY RECORD Dale: r- ;79y <br /> RETAIL ENVIRONMENTAL - Serial No: 99a��.T-�1 ❑ of <br /> ENGINEERING WEST Page � 7 <br /> Sile Address: <br /> r� 2575 Country Club Blvd. , Stockton, CA Analysis Required LAB: set(1t'I .' <br /> WiC <br /> 204--7524-35Q5 CHECK ONE(1)SOX ONLY CT/DT TURN AROUND TIME <br />' � <br /> C_W, Monllomg ❑ u41 <br /> Shell Engineer: Phone No.: 510 24 houn ❑ <br /> Alex Perez Fal : 616$ SR a Invadlpafron ❑ 't"I-6172 �61,a�,r. ❑ <br /> Con l(,��I![(of N mQ ddre so,ckL„ ro� io1 u.2 <br /> Maine 1'ecil Jervlces. Inc. ❑ 16 day, ❑(Hammad <br /> 1680-Rogers Ave. San Jose CA 95112 X wd.r <br /> to Cla„Yy/Dlspo,al ❑ 3 Olhar ❑ <br /> Consullan! Conlacf: Phone No.; 408- <br /> 573-0555 @ N SoR/AY Ram or Sys. <br /> k Fran Thi a '^ " m ed / O M 0 U12 <br /> lFax #: 573-7771 17 ID Q tn -Q non: Nallry lob m <br /> Comments: G .6 D N Owl r RaaL ar Sys. ❑ "Ss wean at 10911bl•of <br /> 0 D ti� ~ 71/18 hn. IAL <br /> O O 0 u� <br /> to Z Olh• <br /> ❑ <br /> !Sampled by <br /> ' o N � >-° ❑ eCo to c UST AGENCY: <br /> Prinled Name: <br /> .. ° <br /> 6 SAMPLE d aa MATERIAL <br /> W ` nNo,of j j ONpITIO <br /> N/Sample ID Dale Sludge sou Water Alr DESCRIPTION <br /> COMMENTS <br /> VV\w <br /> a r <br /> �U vV\t,J- `� X x <br /> CW C� _ x = �j 2 <br /> qf <br /> & x x n <br /> Relinqul a By a a): Prinled Name: ��,L Dale: Z>• RQcoh (slgnaluro): Prinled Noma: Dale: -vP <br /> `�7GV�Si rr Time: Y �2,DL- ,h v <br /> Rolinqu! 9d ( lura): PNlnlad ama: Dale:/. Rocelved(sign re _. Prinled Noma: <br /> Dolo; <br /> O Time. Flma: <br /> Raunqulshe By(slgnaluro); Prinled Name: Gate; Recelved(slgnaluro): Prinfed Noma: `pale: L Y <br /> Ilmo• cJ Tuna: <br /> • n..ao.,wwbw <br />
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