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ARCHIVED REPORTS XR0003436
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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 XR0003436
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Entry Properties
Last modified
6/24/2019 11:54:18 AM
Creation date
6/24/2019 11:09:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003436
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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a Analytical <br /> Chesapeake Dr EXXON CO ANY, U.S.A. <br /> Redwood City,CA 94063 P 0 Box 2150,Houston,TX 77002-7426 <br /> (415)364-9600 FAX(415)364-9233 CHAIN OF CUSTODY <br /> Consultant's Name: F f+I _ Page of <br /> Address- T .w ) Site Location: G <br /> Project#• Consultant Project# _ Consultant Work Release#: 3oc> 0 <br /> Project Contact � ,,� 1J�,v4'-�f � Phone# C� [,, �3�. � p�y Laboratory Work Release#: p�-�(0%Q [ <br /> EXXON Contact Phone # A onEXXON RAS#• 7 - 31705 <br /> Sampled by(print) ���,�� t�� l+yr �j� Sampler's Signature <br /> Shipment Method Air Bill# a. <br /> TAT: ❑ 24 hr ❑ 48 hr Cl 72 hr ❑ 96 hr Standard (10 day) 47fQ ANALYSIS REQUIRED <br /> Sample Collection Collection Matrix # of Sequoia's TPWGas TPW s M H m1'�r TemperaWm <br /> Date Time Sod/WalerlAlr Prsv 8TEX1 Diesel <br /> Description Cont Sample# 80151 EPA 5520 � v InbmWSesl Yes No <br /> 8020 8015 Oubximl Sial Yes No <br /> 0 <br /> Cr <br /> in <br /> o <br /> pin <br /> Ob 67 <br /> 0 <br /> m <br /> RELIN ,,q,q7D1flY/AFFILIATION Date Time ACCEPTED/AFFILIATION Date Time Addltlonal Comments <br />
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