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ARCHIVED REPORTS XR0003742
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 XR0003742
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Entry Properties
Last modified
6/21/2019 8:55:38 PM
Creation date
6/21/2019 4:38:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003742
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 CUSTODY RECORD Date: '-•b.-q7 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No: Page ;� of <br /> Site Address: , <br /> 9,5757 (0�IkAft U uL bl Jct Livoc rw �jjzju Analysis Required LAB: S eo ugi k <br /> fC : <br /> 204- 7 5 A� _ 3 S��- ry CHICK ONE 11110x ONLY cu01 TURN AROUND DAZE <br /> Shell Engineer: Phone No.: 510 s W AdoaRodnp 04461 24 hww <br /> ❑ <br /> Iv p rt7~ 1FWX-.-5b"-' <br /> sue InwsUpolon M4111 4i hoursaConsullant NmeCAddress: tag CkusUy/DWposal ❑ "43 <br /> dSdoyl �INormap <br /> Cambria, P.O. Box 259, Sonoma CA 95426 Wcder <br /> 0 ClassUy/nkpasal ❑ 4u3 ah.r ❑ <br /> Conwllonl Contact. Ph# 707-935-4854 a <br /> .. <br /> to Sop/Ak Rams or Sys <br /> Joe Neely Fax 935-6649 B so o a m ❑ e53 <br /> ziQ La NOTE. NoWytab= <br /> a. �-- Walaf Ram.a Sys loon as/ouk"of <br /> Comments: ,ri ,� �u ORA{ ❑ 4463 24/48 Ru TAT <br /> 2 2 Z olha El~ ai <br /> Sampled bY:J p r r o c m a <br /> Q m 21 a 0 N o UST AGENCY: <br /> Printed arae: (K fjU4 V a m o A 1 a p SAMPLE <br /> � -- E rL MATERIAL CONDITION/ <br /> Sample ID Bala sludge Soil Watet Alt No °t z o m o m O DESCRIPTION <br /> conte. j'' f� m > u U a. u COMMENTS <br /> Lkw `l <br /> 01112 SI <br /> R B pna e): PT n Na . Dale; -1 f ) Rece ( gnatute)Qh7Printe Arne. palms, <br /> Rina .v I f6G <br /> R bysl atyra): Rhin N pate rz-r�-; Rece ed(dg r ). Pawdef Name: e. <br /> rT1e; <br /> Rrritnquishrd 0 arae: Hetet Received(slgnatu : Prinled Name. n [Date. 11 <br /> Time: Z I Irl .1Jd ,V TlrrTe: 2 <br /> • w.ranw a <br />
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