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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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0 9 0 1 <br /> SHELL OIL COMPANY CHAIN OF CUSTODY RECORD Dale: JL/--3/97 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Sorial No: 27i z 7-3Page f of <br /> Silo Address: -r <br /> 2575 Country Club Blvd. , Stockton, CA Analysis Re ulred G")� d: f �sa14 <br /> WICR: <br /> 204-7524-3505 i� H[cfcDNET11sox ONLY CT!!?T TURHAAOVMCrifA[ <br /> `�� G W Monlorinq ❑ 4441 <br /> Shell Engineer: Phone No.: 510 24houn ❑ <br /> --6168 ) $11a lnvol9odlon ❑ 4"] <br /> Alex Perez Fa�C7 - _ \ i' 41 noun ❑ <br /> ContllilcTl N?m�& ddfess• Inc. Sol CkwVy/Dkpoval ❑ 4112 16aart <br /> a ne ec ervices, <br /> co <br /> 1680Ro ers Ave. San Jose CA 95112 x wale' <br /> o �� clwrlfy/Dbporal C] 4U3 other ❑ <br /> Consullanl Conlacl. Phone No.; 408-- <br /> 573-0555 °' SoUlAk item of 3yr. <br /> Fran Thie Fax N 573-7771 a m ,�; °' Cl "S2 NOI[ HallryLob as <br /> Cammenis: a u o J n 4 Norm at sr. Icon 10066R <br /> AO of <br /> .O ,O �y ,© 24141hrr lAT �J <br /> v Co <br /> O O O w U <br /> Crx�-- Ocher ❑ <br /> Sampled by: � ID <br /> 4') Ul ON a? I)Q1 n O � <br /> d ID <br /> r w M H 4, UST AGENCY: <br /> CO co <br /> X11 � N <br /> Printed Name: ..., a 2 ;; 'v c a <br /> ° yri CL SAMPLE <br /> b o v wo CONDITION/ <br /> No of MATERIAL <br /> Sample ID Dole Sludge Soil Waler Ali DESCRIPTION <br /> conls m j <br /> u 4 6 at U COMMENTS <br /> S <br /> C <br /> outs By(slgPrinlad Nama. Dale Received (slflnalure) Haled Name.Time lb TImi?, <br /> Tale <br /> 5 <br /> 'od By(slgnolure)' Prinled Name. D`aio RocoNed (slgnalure), Pfirtilod Homo. Dole, <br /> Time Tlma <br /> NY(slgnalure), Pr nlod Nome Dale Rocolva¢(slunalure) Pdnler arrw Data 1L 3 I <br /> Time �w � Time wsr, <br /> TIJE LABORATORY.M!lKERr?VIDC A GQPY_OF T1115 rIfAIP OF rU5TQMWITIi MYQIQFAMn RU <br />
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