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ARCHIVED REPORTS XR0003450
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 XR0003450
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Entry Properties
Last modified
6/24/2019 12:39:53 PM
Creation date
6/24/2019 11:16:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003450
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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80 Chesapeake Dr L-AA%_0iI vSon, <br /> "Jw Iy ILA.%A r-+• <br /> edwood City,CA 94063 PO Box 2180, 7X 77002-7426 <br /> 0 <br /> K15)364 9600 FAX(415)364 9238 CHAIN OF CUSTODY <br /> Consultant's Name A � ��, Page _ _ of <br /> Address. <br /> Site Location c,aGTO <br /> Project If Consultant Prosect . Consultant Work Release N. <br /> Phone # ��' f Laboratory Work Release It C <br /> Project Contact. _ - ���. a) <br /> EXXON Contact /' q �-7s& - phone # EXXON RAS 4 �C� U <br /> Sampled by (print). T� �j'l— �/�5 Sampler's Signature. _ c <br /> a_ <br /> Shipment Method. G Air Bill # <br /> TAT. ❑ 24 hr ❑ 48 hr '0172 hr ❑ 96 hr Standard (10 day) ANALYSIS REQUIRED <br /> Sam ie Collection Collection Matrix It of Sequoia's TPH/Gas TPI I/ TAPH Je,,,perd,L„e <br /> P Data Time SoltlWaier/Alr Prsv Cant Sample It $01X1 S <br /> ae <br /> heSCflptlOn arn� 130151 EPA IPA 5520 inboundSeai Yez Nu <br /> 8020 8015 ()uw <br /> lbuid Seal Yes No <br /> 0 <br /> Cr <br /> �.tr/�I✓�i C5 r;��� N <br /> a <br /> 1`15�1NQUISH5D BY/AFFILIATION Date Time CC PTEO/AFFILIATION Date Time Addflrona!Conm anis <br /> - L - <br />
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