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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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ELL OIL COMPANY CHAIN OF CUSTODY RECORD Dale• Pc-g7 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No: Page a of z <br /> 15118Address; Analysis <br /> a • [u b t3�uc� S �k G� G�o Y Required LAB: S4cwc, <br /> riih—ell <br /> 204- 7 Ya 9-3soS <br /> CHECK ONE({)SOX ONIY CT/DT TURN AROUND 1k1dT <br /> • rK G W M.,N.dny it/1 <br /> ngineer: Phone No.: 5 Z0 � Z4 hoursFttk'�R: �psr.rnvesilgal>on [1 <br /> i/Nounlant Name&Address: log Clw VVIDlrpom) ❑ 4443 <br /> Cambria, P.O. Box 259, Sonoma CA 95476 a° Wraer 1/days ff1Nor+rwt{ <br /> Consultant Conlach Ph# 707-935-4854 s ClasrRrrD4poral ❑ ius other ❑ <br /> Joe Neely Fax 935-6649 g d Soll/ADa�A4pimo'Sy. ❑ ul= <br /> to Q N NOTE. NoIVV tab w <br /> 0. �- Water Rom.or Syrr soon as 1POSIR o o1 <br /> COlnmenls, O d L�T o a M ❑ tt6s 2414/hu IAT <br /> 0 x12 N Z Other ❑ LL, 19 �^ 33 <br /> Sampled by. J w a 1d O c a �z <br /> o aD L) & 0 +� C m UST AGENCY: <br /> ' H ° <br /> Pdnled Name: � I c o' <br /> E-' T ° E E a E MATEtiIAI, SAMPLE <br /> CONDITION/ <br /> Sample ID Date Sludge Sol) Water Air No,of ac o d O a d o DESCRIPTION <br /> cants. as > r— U U a. U COMMENTS <br /> Nt <br /> ���- 6�►S • �M�, _ o� lel <br /> Mw I�- 6�{5 h L� <br /> w �l� <br /> -$I l� <br /> R y gna e): Points Npyne: Dole. Rac tvad( nature). Pointed Name, Data./ <br /> J� ,S r. <br /> r' O <br /> R y(dgnTature): Prinlad Name: Data- Z Recaly (Tama Prinled aryw: e• <br /> � <br /> R P ature • Dale: Rocelved(/lgnatut Prinled Narne. Date: l <br /> TIMN: AILX- 7 :) I114STHE[ABORATORY MUST PROVIDE A COPY OF Tills CHAI"- L&USTODY WITH INVOICL AND RESULTS J <br /> IiTTTs: <br /> n.laaEn N <br />
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