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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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u�iytie� � � � �(O�O�NI�S.� � � >• � � <br /> Chesapeake Dr <br /> Redwood C.ity, CA 94063 P O Box 2180, Houston,TX 77002-7426 <br /> (650) 364 9600 • FAX(650)364 9233 CHAIN OF CUSTODY <br /> Consultant's Name _ ' �� � �� ��� <br /> _ _ Pa e of ---- <br /> Address st 1�14 6no �, r6,Lw4 — Site location <br /> Project # Co sultant Project # _ Consultant Work Release # <br /> Project Contact � Phone # Laboratory Work Release #� c� <br /> EXXON Contact a V-i - Phone # EXXON RAS # — <br /> le- <br /> Sampled by (print) �� Sampler's Signature <br /> Shipment Method �vy,� Air Bill # <br /> TAT U 24 hr D 48 hr IJ 72 hr -J 96 hr Standard (10 day) ANALYSIS REQUIRED <br /> TPHICas TPHI TRPH — remperatuie <br /> Sample <br /> Collection Collection Matrix Prsv F of Sequoia's BTEXI Diesel S M - — <br /> Description Date Time Soil/Water/Air Cont Sample # 80151 EPA 5520 �ZL� n Yes No <br /> 8020 8015 3ut obound SSeeal Yes No <br /> �.U- O-2�S 5 v o �r � �A <br /> o <br /> r — – <br /> Tv <br /> O <br /> C- <br /> RELINQUISHED B F LIAT10 Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> r <br />
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