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ARCHIVED REPORTS XR0003336
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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2705
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3500 - Local Oversight Program
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PR0544595
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ARCHIVED REPORTS XR0003336
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Entry Properties
Last modified
6/24/2019 12:24:17 PM
Creation date
6/24/2019 10:10:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003336
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Cham of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office O77 Sacramento a Addit,onai documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 __ _ Job Name 7-Eieven Store#14117 <br /> Rancho Cordova CA Location 2725 Country Club Blvd. <br /> Stockton,California <br /> Project# 77EL 14117 43 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Klff Analytical !� T <br /> Turnaround Time Standard <br /> w $ 4 m t3 � O <br /> Sampler's Name Danielle Catlin-Wright <br /> O co UO �O tE0O g � S <br /> Sampler's Signature o 1p = b V� g €� S Comments/ <br /> Sample I Date Time Ma rix i m I m v",w w w Instructions z <br /> Ll - S' 04/21/03 I a`i sou xI x x I1 0� <br /> L. - 2.1t X X X 1 of <br /> 52' 5,69 x x Oq <br /> Special Instructions/Comments Relinquished by Received by Sample Receipt <br /> 5 Oxygenates TAME,MtBE, EtBE,TBA,&DIPE Sign YSign Total no of containers <br /> email results to Jauchterloniefsecor corn Print jrAratv. 'Print Chain of custody seals <br /> Company SgCo _ Company Rec'd in good conchonbold <br /> Time 5Z Date Time Date Conforms to record <br /> Relinquished by Rdrceived by <br /> Sign Sign 4 Client SECOR <br /> Print Print Client Contact Jaff Auchterionle <br /> Com Company ki K Client Phone (916)a61-0430 <br /> T Date Time VaL Date +d -o ext.241 <br /> sEODR aUSTREC Aft 2W <br /> Date -Z -d'3 Page <br />
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