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ARCHIVED REPORTS XR0003449
EnvironmentalHealth
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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 XR0003449
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Entry Properties
Last modified
6/24/2019 12:34:45 PM
Creation date
6/24/2019 11:16:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003449
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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la Analytical , EXXON COMONY ! <br /> Ilesapeakeake Dr , U.S.A.. <br /> Redwood City CA 94063 P Q Box 2190,Houston,TX 77002-7426 <br /> (q}5)364 9600 FAX(4 15)364 9133 <br /> CHAIN OF CUSTODY <br /> Consultant's Name. �/l c- le6A �� 1 XPi i `�� lzr 1 < / �rl i ! �5 _ Page <br /> Address. 1 ��/� �li�r�, �� Site Location S-rtaG�-rrtiJ <br /> Project # Consultant Project #. Consultant Work Releasell 093M11 y, <br /> �� Ph #. 1 U Laboratory Work Release# <br /> Project Contact. %���� r1 (a1 one <br /> EXXON Contact Phone # EXXON RAS #, - 3 709 U <br /> Sampled by (print) ��; ,� S-!�, ,�� Sampler's Signature ,-„ ,-' <br /> Shipment Method (icy. ,Y1 Air Bill It r <br /> TAT ❑ 24 hr 1:148 hr ❑ 72 hr ❑ 96 hr Standard (10 day) ANALYSIS REQUIRED <br /> Collection Collection Matrix it of Sequoia's TPH/Gas TP11/ TRPH Temperature <br /> Sample Prsv 0 FEX1 Diesel 5 M <br /> Description Hate Tune SOIt/WaledAlr Con[ Sample It 8015/ EPA 5520 Inbound Seal Yes No <br /> 8020 EPA OulboundSeal Yes 110 n, <br /> 15 <br /> O <br /> Q <br /> (,1 Q� wz v 3 I cn <br /> f 3 <br /> m <br /> } <br /> lrZt <br /> 1216 \U <br /> I � <br /> RELINQUISHED BY/AFFILIATION Date Time AC�fiPTED/AFFILIATION Date Time Additional Comments <br /> 410 �m1n, <br /> �cl� /S /r t lt( � <br />
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