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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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Analytical EXXON COMANY, U.S.A. <br /> tDSuola <br /> 680 Chesapeake Dr <br /> Redwood City,CA 94063 P O Box 2180,Houston,TX 77002-7426 <br /> CHAIN OF CUSTODY <br /> (415)364 8600 • FAX(415t 364 9233 <br /> Consultant's Name. :C� LL;—& Page of <br /> Site Location <br /> Address. - <br /> Project#. Consultant Protect#. Consultant Work Release#. <br /> Phone#. <br /> Protect Contact. � Laboratory Work Release# c <br /> v� T <br /> EXXON Contact. (Q Phone #: EXXON RAS#. 3 U <br /> x <br /> Sampler's Signature: <br /> Sampled by(print)::R6- <br /> Shipment Method, t,.p Air Bill #• <br /> TAT. ❑ 24 hr ❑ 48 hr ❑ 72 hr ❑ 96 hr tandard (10 day) ANALYSIS REQUIRED <br /> Collection Coitection Matrix # of Sequoia's TPH/Gas TPHTRPH Temperature <br /> Sample <br /> Date Time Soil/WalerlAir PrSv Cont Sample# 80 5w EPAeI 5520 /y] Qy Inbound Seal Yes No <br /> Description <br /> outbound Seal Yes No al8020 8015 <br /> 0 <br /> a <br /> Cr <br /> U) <br /> 30 70 L ' <br /> Gv- <br /> Crro <br /> Z� <br /> 4) <br /> RELINQUIS Ep BY/ FILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional comments <br /> /J(�2 / 1 <br /> G <br />
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