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ARCHIVED REPORTS XR0003428
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 XR0003428
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Entry Properties
Last modified
6/24/2019 11:43:25 AM
Creation date
6/24/2019 11:04:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003428
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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HOUSTON LAE30RATORY <br /> 8880 INTERCHANGE <br /> DRIVE <br /> HOUSTON TEXAS 770547054 <br /> �9,.703WR0000r <br /> (713}660 0901 <br />' Sample Receipt Checklist <br /> Workoidei 00110263 Received by Steliy DAPna <br /> Date and TEme Received 1119140 10 00 00 AM Carrier name FedEx <br /> Temperature 4 <br /> Shipping container/cooler to goad condttton'� Yes JNo Not Present <br /> Custody seals vitact on shippping container/cooler? Yes No _ Not Present <br /> Custody seats intact en sample potties? Yes No _ Not Present W <br /> Chain of custody present" Yes J No _ <br /> Chain or custody signed when rehnquisned and leceived? Yes J No <br /> Chain of custody agrees with sample labeis? Yes No <br /> Samples in groper container/bottle? Yes No <br /> Sample containers intact? Yes No <br /> ' Sutttctent sample volume for indicated test-' Yes J No — <br /> All samples received vtthtn holding times Yes J' No <br /> POntatnei/Tenip Blank `emperature in compliance' Yes V No <br /> Water ADA pals lave zero heacspuce Yes J No Not Present <br /> Water prl accep°able poen rP,,ipf Yes J No <br />
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