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ARCHIVED REPORTS XR0003752
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 XR0003752
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Entry Properties
Last modified
6/21/2019 9:27:24 PM
Creation date
6/21/2019 4:43:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003752
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 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serlol No ���14o2s`y� Paco of f <br /> Silo Address <br /> 2575 Country Club Blvd Stockton, CA Ar)alyslS Requlrec! LAR: <br /> WICC cnrcic out(1)rox oiltr CT/DT TURII AROUNn WI[ <br /> 204-7524-3505 <br /> Cw S.Jonllolrng ❑ 1141 alnuan ❑ <br /> Sholl Enginoor. Phono No 51() <br /> F 1�2�j—6168 •`y 3!.Inv.�ilQc!!on ❑ 1Jll <br /> � 11 Noun <br /> Con Hut N�m4 &SAddross ❑ <br /> Soll Ciaully/DUParal 444] IS dayr lilorrnali <br /> alne ecl ervices Inc. w <br /> wal.r � <br /> n r San Tose CA 95133 c� x Clor,lfy/p�Po�al 4413 ot1,.r 0 <br /> Consultant Contact P�,.,nq NY /108 <br /> a N SoAIAL R.rn or Sys E)Iran Thio <br /> Fax 9 7cn-8773 ° °' ¢ .n Ed a• HorT ilolllYLob a; <br /> N [L Wd•rRem orSys 4JS3 soon aspoollus.at <br /> COmmQnIS <br /> ,w o O.M ❑ 34141 his [AI <br /> O �, <br /> z Met C]Sampled by. a o o c N >- <br /> Q Q W � N a 19 UST AGENCY: <br /> � <br /> fl- <br /> v N oPrinted Nam©. � 0��p a- � L" a+ " a <br /> SAMPLE� o a- MATERIAL a <br /> CONDITION) <br /> No of x x rat N o o �► o DESCRIPTION <br /> Sample 1D Dalo SludQa Soil Vlalor Air ,, o U U U COMMENTS <br /> COnli r— �_ m y <br /> /rte f`� - - -- COdI��-1�y�^ <br /> o/, <br /> 114 b <br /> 10/1 <br /> Rat h0 �a rfln <br /> 0) Pilnl d Name r Dato til it t <br /> 2 �� R �ulvod (; oluio) Pllnlaq Noma. Data [J <br /> �e, <br /> Ralinglsl r,d 8y slgnalura} Printed Noma Dolo Rocalvad (SlQnaluro) Pilnlud Name <br /> / Tlm_o ITIMQ <br /> Rollnqulshed By(sIgnalur0) Primed Noma Dalo Rocolvud (slgnoluia) Prinlad Home Dale <br /> 111no nma <br /> E jgDORATORY 1A951 PRQYIDE A COPY QF 11 1�L�11�IS2LYSY1 11�Y�ISt A 1?� l ado�Mw,,, <br />
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