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ARCHIVED REPORTS XR0003435
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 XR0003435
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Entry Properties
Last modified
6/24/2019 11:51:14 AM
Creation date
6/24/2019 11:09:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003435
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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TI ' ' "= M = M EVAN gMftY, F.W.A.M <br /> Chesapeake Dr WJ <br /> V- 1 <br /> City,CA 94063 P C Box 2180,Houston, TX 77002-7426 <br /> (415)364-9600 • FAX(415) 364 9233 CHAIN OF CUSTODY ' <br /> Consultant's Name: Gf Page r of <br /> Address: V14 hr/ v -pi— Site Location rx - "- <br /> Project C Consultant Project# D09 Consultant Work Release# 930000 <br /> Project Contact: * -1` Phone # 9i-LAS- 'Z, t-j Laboratory Work Release# <br /> EXXON Contact:, r�" Phone # EXXON RAS # <br /> Sampled by(print) ��iti ` fi Sampler's Signature <br /> Shipment Method. Air Rill # d <br /> TAT: Q 24 hr ❑ 48 hr ❑ 72 hr ❑ 96 hr Standard (10 day) ANALYSIS REQUIRED <br /> Sample Collection Collection Matrix # of Sequoia's TPHIGas TPH/ TFIPH MI Temperature <br /> Date Time Soil/Water/Air Prsv BTEXI Diesel S M <br /> Description Cont Sample # 80151 EPA 5520 Inbound Seal Yes No <br /> 8020 8015 Outhound Seal Yes No ca <br /> Cr0 <br /> y� <br /> i 'IIA/ <br /> 1 d 0 liil <br /> OIL <br /> rA07ur ��a1 <br /> a <br /> tA'4/ <br /> o1,V <br /> I L <br /> REL HED BY/AFFILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> ( J l� <br />
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