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ARCHIVED REPORTS XR0003434
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 XR0003434
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Entry Properties
Last modified
6/24/2019 12:01:27 PM
Creation date
6/24/2019 11:07:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003434
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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y '`w = = = MO ISO ONN YPOS AM M M I• <br /> T—Dhesapeake Dr <br /> Redwood Ctty, CA 94063 PO Box 2180, Houston,TX 77002-7426 <br /> (650)364 9600 • FAX (650)364 9233 CHAIN OF CUSTODY <(C- C, C ( � <br /> Consultant's NameDe- �I f�rn �-- �,� - DC-- Page _ of <br /> Address l �--- -- <br /> 31 l� f r Site Location C]� <br /> Protect # Consultant Project # <br /> 1 -�G�2�� ��� — Consultant Work Release # <br /> Project Contact Phone # �G���1 _2 Laboratory Work Release r# —_ <br /> EXXON ContactC7� '� <br /> ITcc/l �. Phone # EXXON RAS # fl � v <br /> _7C <br /> Sampled by (print) Sampler's Signature Y <br /> Shipment Methodv Air 0- <br /> Bill # Y - ---- -- T L1 ' !o <br /> TAT ID 24 hr r_i 48 hr Ci 72 hr 1�1 96 hr Kstandard (10 day) ANALYSIS REQUIRED <br /> Sample Collection CoTPHIGas TPHI TRPH �O%E Temperature <br /> Collection Matrix Prsv � of Sequoia s BTEX/ Diesel S M <br /> Description Date Time Soil/Water/Air Cont Sample # 80151 EPA 5520 } Inbound Seat Yes No <br /> 8020 8015 0}tbound Seal Yes No TO <br /> Sal L /J <br /> Z --2f—Aa,5 3T <br /> SCS - - kS 1155 <br /> -- --I (5 2-55 I t <br /> RELINQUISHED BY ILI TION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> �✓ 5-2-3 6,ow <br /> � � - s. 2 <br />
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