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ARCHIVED REPORTS XR0003743
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 XR0003743
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Entry Properties
Last modified
6/21/2019 9:32:03 PM
Creation date
6/21/2019 4:40:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003743
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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SELL OIL COMPANY WHAIN OF CUSTODY RECORD <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Sorlal No. q7/]y2-2-/ Page- of-?— <br /> Silo Address: <br /> 2575 Country Club Blvd. , Stockton, CA Analysis Required LAB: ���1oi,� <br /> MCC <br /> 204-7524-3505 , CHECKONE(I)IOXONLY Cf/pI TURN MOUND'hMt <br /> Shell Englneer: Phone No • 510 L\ GW, MOR106np "61 =4hpu <br /> Alex Perez FI 7�-6168 316lnr•dlpolon [] 4" �IAnun [� <br /> 675-6172 <br /> Con tilla�nf N� c? &SAddjess• Inc. �' 3o1c1ouYy/Drpoiat <br /> a ne ec 1 ery ces, „� ❑ `"" IS days (Normop <br /> 1680 Rogers Ave. San .lase CA 95112 x wars <br /> Consullant Conlacl: Phon© No.; 408 v Ckusq/Wipal C) "43 Olhor ❑ <br /> ` <br /> a <br /> Fran Thie 573-0555 N N N m SoR/0R•m at Sys <br /> Fax N 573-7771 0 OAM ❑ us: <br /> Comments: _ c� �EX. - N NOr[ NaEtrylat,or <br /> Wnr.r R.m or Sy, ►aon or ressuo o1 • <br /> �� l / a ✓ D �7 a ��: G O A M ❑ d1S7 24/41 his IAr <br /> A �� N <br /> b <br /> a03 C4 (x c h N <br /> , olh.rSampled by: n N o o c <br /> Q - N UST AGENCY; <br /> a oPrinifld Name:L9J 6-j'Ici` o <br /> o <br /> '0 SAMPLE SAMPLE <br /> x -6 ° MATERIALSample ID Dara Sludge No o! o E° j ° � ° DESCRlPTtOCONDITION/ <br /> conk NCOMMENTS <br /> /UTA/ <br /> 0 <br /> El-1 1. 1 <br /> nlw 11 I <br /> Ro o gnaturo): Prin ad Namo polo ^ Ro ivod (slgnaluro). Pr� mno. Dolo: x <br /> 6 In i r <br /> o c <br /> R q o B gnolwe) Prinlad F ma la Z IV RocoNod (slgnoluro). Prinlod <br /> llnNamo: Dole:- 26 <br /> Raqufthrd 6y(slpnotura), nma nmo:cjla R Iv { lpn ro) Pr d hams. <br /> Tlmo eY✓� wn. Dole: <br /> n+a w <br />
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