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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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LL UIL tt;;u rANY HAIN UI• GUbIUUY NLL;UNLJ pare <br /> VRL ,l! Ll <br /> ENVIRONMENTAL ENGINEERING - WEST Sertal No: g [ j <br /> Sita Address!2.�;7 <br /> 5- 60GW (A(4Z $1u 1&� p Analysis Required Rj)ai7l I LAB: ! u o N <br /> LICM. 204_ �,�d L) - jSDSr CHECK ONE(1)sox ONLY Cr►or TURN AROUHD DUE <br /> G W rAanlo�lap ❑ 4111 ❑ <br /> She) ngtneer: Ph�n_e No.: 510 2'train <br /> Pe4tZ F,'A� SY.Im.dlpdton M {u{�j'r��( TSG 1 .03 dR Aowt [I <br /> Consultant Name&Address: souCka,gylobPasai ❑ 4142 {sdays M(Harmo <br /> Go <br /> Cambria P.O. Box 259 Sonoma CA 95476 4443 <br /> S T .. CIw�IIylpkpoaat <br /> Consultant Contact: Ph# 707-935-4854 0 aha+ ❑ <br /> .. Sawk Ram at Syo <br /> Joe Neely Fax 935-6649 �_ .a a A"' ❑ "6 <br /> 2to HatE NoIRIr LaL w <br /> (' in Wola Ram.of$To 100(6 a6 Pwlrala W <br /> Comments: v ti o.u ❑ 4'�' :flu��� ar I9 1 33 <br /> 1 2 w zto olds ❑ <br /> Sampled by: 0— <br /> w b p G f� } <br /> a so g) a 0 t m UST AGENCY: <br /> Printed Name: o`C a O ° c N' <br /> �I <br /> SAMPLE <br /> �' ° E c E MATERIAL CONDITION/ <br /> Sample ID Delo Sludge soil Water Air No.of = :co a, O 0 a DESCRIPTION COMMENTS <br /> conls N m > r U <br /> Mw 66,S X as <br /> R ay gna o): <br /> Prinled Name. Dale.! Recelved nnature). Pr lad Name. Date: fy <br /> s- o,s- <br /> R y signakus): PEIr})�d Noma: Dale• I Recut (6lgn ): Prfnle arrw: e. <br /> • � lima. <br /> Reil By alure): Prinled Na . Dale. Received{signaler Prin a me. Date: 1-2--1 <br /> mddcd o <br /> a <br />
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