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ARCHIVED REPORTS XR0003754
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 XR0003754
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Entry Properties
Last modified
6/21/2019 9:35:46 PM
Creation date
6/21/2019 4:50:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003754
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- <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serial No: Pago of <br /> Site Address. Analysis Required LAIN: SQ <br /> �f 2575 Countr Club Blvd. , Stockton, CA Y q <br /> %VIC#: X11 CHICK OUT(1)BOX O111Y CTIDT TUR"AROUND 111.IL <br /> 204-7524-3505 <br /> L Shell Engineer: Phone No : 510 C W Monrodno ❑ "al 34 hours ❑ <br /> �' <br /> R. Tefsr 6rtt6e" Fax? -b 1 b 8 Sr&Tnrorllodlon ❑ 4"1 48 hears ❑ <br /> ConylQnl Ve &SAdd�r3ss: Inc. Se1lclassYylGlrposal El 12 ❑ <br /> a lne ec ery ces, l6 days (Norman <br /> Wolof <br /> 985 Timothy-Dr. , San Jose CA 95133 w clauYy/Dlapo�aT ❑ 1113 ❑ <br /> Consultant Conlact; 1POT qp ; 408 v afn.ri'ran This r��j5 0 N sou/Ar Run of Sys <br /> Fox 293-8773 O °i 4 co n 0 U ° M ❑ ��s7 Half Holly lob as <br /> 0 O a Warr Rom.of Sys soon as yorslWa of <br /> Comments: N W o oafl ❑ ass 24149 his t,►1 <br /> o co <br /> S O U Z alhor ❑ <br /> +Zs <br /> Sampled by. on a o c , <br /> A-,JD� ,\r� �-1 Nr b � GO M C. Q o a USTAGENCY: <br /> d <br /> O U <br /> W <br /> °Prinled Name: a o <br /> SAMPLE° w MATERIAL ONDITIO <br /> N/ <br /> No of to m aSample ID Dole so 5011 Wafer Air o UD+SCRIPTION <br /> conls > COMMENTS <br /> X1.1✓.' z yz� 12 1!� x 21 — X —— — r <br /> D <br /> 4,7W- 3 12A0b�- <br /> � � , 03 <br /> C�-( <br /> Pup 3 x o6 <br /> 1� <br /> 1-C gUthod (sl to Prinlod Name. Dale Received (s1 n luno) Ninlad--{Norm+. L Dale ��47, <br /> I tl r 'nmo Cry�hV �IO`U ls- A !O <br /> shod (slQnq o), Pllnlad Noma. Delo � - acoNad Iflnafvro) <br /> Date, <br /> y t M1 ^t1 Jd 6nx Tlmonmo <br /> .� By(sip tura) Pr1n1a /a Dale RocoNad(sl ur Pflnlod Noma. rteDnla. <br /> Tltno C , 1 160 , Time j� <br /> iiIFJABORATORYTMU51 PRUDE AQQEL.QEIl115&jj911L2 INVOICE AND <br />
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