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ARCHIVED REPORTS XR0003447
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 XR0003447
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Entry Properties
Last modified
6/24/2019 12:10:15 PM
Creation date
6/24/2019 11:15:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003447
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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betlliold A11diyW dl EXXON COMPANY, U.S.A. <br /> 680 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--D -� F Page —L—of <br /> n.i J+2.a�rVl G+v�[. C11tiI SV C,?xl-N`TS I A1C <br /> Address. A-m p Sv Zan `Zp n/C.edca —Oafek Lz& CA Site Location, <br /> Project# Consultant Project# Consultant Work Release 9, moo 0 <br /> Project Contact -�-Ob� AL Phone# t 8—ZD�'� Laboratory Work Release # �- <br /> � �I <br /> EXXON Contact M A.&L4 GtJ E+�}S _ Phone# SIO (o — 2 7 710 EXXON RAS# 7-3 U <br /> Sampled by(print) 3 Sampler's Signatur <br /> Shipment Method)>F-L to I'X-L,l � Air Bill # <br /> a <br /> i <br /> TATA64 hr IJ 48 hr I~J 72 hr IJ 96 hr aY) ANALYSIS REQUIRED <br /> Sample Collection Collection Matrix TPH/ TRPH x # of Sequoia's TaML Ternperalure <br /> Date Time Soll/Water/Air Prsv F <br /> Description Cont Sample BTEXI Diesel S M# 80151 EPA 5520 L~'AD Inbound Seal Yes No <br /> 8024 8015 Outbound Seal Yes No <br /> 0 <br /> a <br /> SP - A 1 -/(P-9 33.5 501L- dot1 I oqw <br /> So _ rrPbs,7f <br /> P 3- L X X � ,47- rrg Ldrg <br /> SP - G -I -9 3119� SO/L ►,boa <br /> C r <br /> 0 <br /> a <br /> RELINQUISHED BY/AFFILIATION Date Time ACCEPTED/AFFILIATION Date Time Additional Comments <br /> :A7 <br /> rx� r,-r <br />
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