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ARCHIVED REPORTS XR0003347
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 XR0003347
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Entry Properties
Last modified
6/24/2019 12:30:01 PM
Creation date
6/24/2019 10:51:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003347
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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SJGOV\wng
Tags
EHD - Public
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CHAIN UFY RD <br /> Te ��merica Nashville Division Ph 615-726-0177 <br /> 2960 Foster Creighton Toll Free 800-765-0980 � � r, <br /> 1 M C O A C a 6 7 i G Nashville,TN 37204 Fax. 615-726-3404 <br /> Consultant Name ETIC ENGINEERING Report To Doug Fitzgerald <br /> Address 2285 MORELLO AVENUE Invoice To JENNIFER SEDLACHEK (XOM PM <br /> City/State/Zip PLEASANT HILL,CA 94523 Account# 10236 <br /> ExxonMobll Project Mgr TED MOISE PO# 4504349419 <br /> Telephone Number (925)602-4710 EXT 23 Fax No (925)602-4720 _ Facility ID# 7-3708 <br /> Sampler Name (Print) O�Q ^h- � Site Address 2705 COUNTRY CLUB BLVD <br /> jSampler Signature "�"r� City,State Zip STOCKTON, CA <br /> Preservative Matrix Analyze For <br /> d N <br /> C I co <br /> U) G <br /> C CL <br /> CD <br /> ID QD <br /> Cr <br /> U) cn w ar a F- <br /> m oN E U m O V] �s5' N G D d N f] <br /> Sample ID 1 Description i H Z C7 U LL s i Z i i Z O V 3 o W W s ic a <br /> MW1 i 1,7"1 6 X X I X X I X I I X X <br /> MW4 It JV 6 X X X I X I X I I I I I X X <br /> Al <br /> MW5 II Vy 6 X X X I I X I X I I I I I X X <br /> MW6 I0'3c 6 I X X I X I I X X X X <br /> MW7 VK 6 1 X X X I X X X X <br /> MW8 ji 6 X X1 X I I X X X X <br /> MW9 if 6 X X 1XI X X1 X X <br /> MW10 1213 6 X X X I X X I X X <br /> VEW1 �I j 6 X X X X X XX <br /> VEW3 HZ` S 6 X X X X X X X <br /> Special Instructions GLOBAL ID#T0607700522 EDF FILE REQUIRED Laboratory CommenFs <br /> Temperature Upon Receipt <br /> Sample Containers Intact? N <br /> G 1PrcJeots%73708+PubIIc\QM Pre-Field Folder43708 COC xls]3708 3rd QUARTER VOCs Free of Headspace9 N <br /> R finqulghed by ti y�x iq�. L ,Data Time Received by Date Time <br /> Pelinquished by Date Time Received by estAmedca Date Time <br /> PAGE 1 of i <br />
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