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ARCHIVED REPORTS XR0003442
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 XR0003442
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Entry Properties
Last modified
6/24/2019 12:11:34 PM
Creation date
6/24/2019 11:13:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003442
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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quola Analytical EXXON CO*ANY, U.S.A. <br /> 80 Chesapeake Dr <br /> Redwood City,CA 94063 P O Box 2180,Houston,TX 77002-7426 <br /> (415)364-9600 • FAX(415)364 9233 CHAIN OF CUSTODY <br /> Consultant's Name. ` I Page of <br /> Address, 3 IYAW. ( Site Location: c <br /> Project#• aC� �C Consultant Project#• Consultant Work Release#: <br /> Project Contact• 4�t (C Phone #: �'I�C� _ 2c�C�.S Laboratory Work Release#• •- <br /> c <br /> �, <br /> - 37 <br />� EXXON Contact: Phone #• EXXON RAS#• 0 Sv <br /> Sampled by (print) " Sampler's Signature, <br /> Shipment Method- v r _ Air BIII #• <br /> TAT. ❑ 24 hr ❑ 48 hr ❑ 72 hr ❑ 96 hr Standard (10 day) ANALYSIS REQUIRED 7055 25 <br /> Sample Collection Collection Matrix # of Sequoia's TPH/Gas TPW TRPH Temperature <br /> Description Date Time SaillWater/Air PfSV P 80151 EPA 5520 - Inbound Seal <br /> Cont Sample# No <br /> 8020 8015 W Outbound Seai Yes No <br /> o <br /> X11/�3 -S s dg 1 U) <br /> -1n1'3 lu s \ 3v j YUr' v o <br /> m <br /> } <br /> i <br /> tti <br /> O <br /> t7 <br /> Q? <br /> 07 <br /> I � <br /> L <br /> RELINQUISHED BY/AFFILIATION Dale Time A CEPTED/AFFILIATION Date Time Addldonel confn,enrs <br /> rf _ Il <br /> fP(e-k 0 r`f J i-hl�51 <br /> " lZ �a3� Lac <br /> `� �c Vic_ <br />
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