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ARCHIVED REPORTS XR0003445
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 XR0003445
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Entry Properties
Last modified
6/24/2019 12:31:34 PM
Creation date
6/24/2019 11:15:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003445
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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Cola Analytical EXXON COOANY, U.S.A. <br /> .'`r►� 680 Chesapeake Dr <br /> Redwood City,CA 94063 P O Box 2188,Houston,TX 77002-7426 <br /> (415)364 9604 FAX(415)364 8233 <br /> CHAIN OF CUSTODY <br /> Consultant's Name � Rage ( of L <br /> Address. N (y off( G Site Location. c,tia <br /> Project#. Consultant Project#.'?)0 3.S0,7 Consultant Work Release#,b93&v bL <br /> Project Contact ," Phone#. ,3$• ?OA Laboratory Work Release M. <br /> LD <br /> EXXON Contact. Ue Phone#: EXXON HAS#. - 3 08LASU <br /> Sampled by(print). '� Sampler's Signature. c <br /> a <br /> Shipment Method. tea,, Air Bill #. <br /> TAT ❑ 24 hr C1 48 hr ❑ 72 hr ❑ 96 hr $tandard (10 day) M ' Kf�a ANALYSIS REQUIRED <br /> TPWGas TPW TRPN <br /> Sample Collection Collection Matrix # of Sequoias Temperature <br /> P Prsv BTEXI Diesel s M <br /> Description Date Time 3olkMfater/Alr Cont Sample# 18015/ EPA 5520 Kp� inbound seal Yes No <br /> 8020 8015 Outbound Seal Yes No <br /> 0 <br /> �- to 73-1b eAeo UIrl- IC, <br /> I , <br /> 3 <br /> 0 <br /> lti�v-b o��ro 111 <br /> W- z la <br /> it <br /> y� a <br /> RELINQUISHED BY/A FILL TION Date Time AC FP D/AFFILIATION Date Time Additional Comments <br /> 0 3 �3D — <br /> � a <br />
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