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ARCHIVED REPORTS XR0003444
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 XR0003444
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Entry Properties
Last modified
6/24/2019 12:12:44 PM
Creation date
6/24/2019 11:15:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003444
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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Ci)ao1a Analytical V�/V�/ N CORNY U.S.A. <br /> 680 Chesapeake Dr EAAO >' <br /> P O BnK 2190,Houston,Tx T7002-7426 <br /> wo Redwood City,CA 94063 <br /> (415)364 9600 • FAX(415)364 9233 CHAIN OF CUSTODY <br /> Consultant's Name _ f �, �,112o yPage of <br /> Address yfl Site Location, rb <br /> Project # Consultant Project#. —(60—9 Consultant Work Release#. 348 Q1, L <br /> Project Contact Phone #. Laboratory Work Release#. <br /> m <br /> EXXON Contact. �(p Phone #. EXXON RAS #. — (j <br /> Sampled by (print). Sampler's Signature. c <br /> I% <br /> Shipment Method Air Bill #. <br /> TAT. ❑ 24 hr U 48 hr G) 72 hr ❑ 96 hr CI Standard (10 day) ANALYSIS REQUIRED <br />� �Sample Collection Collection Matrix #OI Sequoia's TPHIGas TPW p eralure <br /> SM <br /> TRPH Tem <br /> Description Date Time SoifflaterlAir Prsv Cont Sam le# 8015/BTEXEPA <br /> 'QleseDescription1Description5520 Inbound Seal Yes No <br /> 80151 <br /> 8020 6018 Oulbound seal Yes No <br /> Q <br /> Cr <br /> a <br /> } <br /> 1 10Cr <br /> a <br /> �-v \V <br /> o'51 I r <br /> RELI QUISHE N Date Time CCEPTED/AFFILIATION Date Time Addltronar Corrrmenrs <br /> 4�2 <br />
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