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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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*�tytc� r Mkol"oONN1�'"Vs.� i• <br /> Chesapeake Dr <br /> Redwood City CA 94063 P C Box 2180 Houston,TX 77002 7426 <br /> (650) 364-9600 • FAX(650) 364 9233 CHAIN OF CUSTODY <br /> Consultant's Name �e.t �} ��cy� Sl Page z� of <br /> Address 3 V �� "V �-C --- Site Location <br /> Project # Consultant Project # � 3 Consultant Work Release # <br /> Project Contact �l Phone # �� �3 -Z3( s Laboratory Work Release # <br /> EXXON Contact ��� Phone # EXXON RAS # 7- 3 O U <br /> Sampled by (print) &-14-11Sampler's S+gnature <br /> _ c <br /> Shipment Method � CJ Atr Bill # IL <br /> TAT ❑ 24 hr ❑ 48 hr ❑ 72 hr I-) 96 hr Standard (10 day) ANALYSIS REQUIRED <br /> TPN/Gas TPH/ TRPH Temperature <br /> Sample Collection Collection Matrix # of Sequoia s BTEX/ Diesel S M <br /> PrsV Inbound Seal Yes No <br /> Description Date Time Soil/Water/Air cont Sample # 8015/ EPA 5520 Outbound Sea! Yes No <br /> 8020 8015 T <br /> Cr <br /> i5 So L rub - -- - - <br /> S <br /> 53 ! 9- 2� 5 52-Z i - -- <br /> 5Z - g 31.5 230 <br /> - <br /> 0 <br /> RELINQUISHED By/ FILIATIQN Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br />
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