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ARCHIVED REPORTS XR0003441
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 XR0003441
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Entry Properties
Last modified
6/24/2019 11:56:39 AM
Creation date
6/24/2019 11:12:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003441
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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_1IftesapeakeDr r—AA N LOUM Y, U.S.A. - <br /> RW <br /> ood City, CA 94063 P 0 Box 2180,Houst ,TX 77002-7428' �! <br /> (415)364 9600 • FAX (415)364-9233 CHAIN OF CUSTODY <br /> Consultant's Name Page of <br /> Address Site Location -� <br /> Project#. Consultant Project# Consultant Work Release#. <br /> Project Contact t Phone # 'ce ? rL Laboratory Work Release# <br /> EXXON Contact. Phone# �� <br /> +� �� EXXON RAS # U <br /> Sampled by (pant) � Sampler's Signature <br /> c <br /> Shipment Method Air Bill # Ci <br /> TAT ❑ 24 hr ❑ 48 hr ❑ 72 hr ❑ 96 hr AStandard (10 day) ANALYSIS REQUIRED <br /> Sample Collection Collection Matrix # of Sequoia's TPHJGas TPF/ TRPH ' <br /> Description Date Time Soil/Water/Air Prs� BTEX/ Diesel S M tLS'1 lli Temperature <br /> Cont Sample# 8415! 5520 Inbound Sea! e� No <br /> EPA (� <br /> 8024 8015 outbound Seal Yes No rz <br /> Q <br /> Cr <br /> Im <br /> z, 4 <br /> J 1 <br /> w A <br /> 5 <br /> �I <br /> O <br /> PqPj ,7 Cr <br /> J <br /> /"11131/ �3 �,!t� a� <br /> ( <br /> I <br /> RELINQUIS D Y/AFFILIATIO Date Time CEPTED I AFFILIATION Date Time Additional comments <br /> Ir ' S/s� SPC'lIUiJJ �zs <br /> � �7 ST-0 " 6 t <br /> 1/ - -2 <br /> eSC 2 I �' -!r <br />
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