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ARCHIVED REPORTS XR0003464
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 XR0003464
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Entry Properties
Last modified
6/24/2019 12:49:39 PM
Creation date
6/24/2019 11:21:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003464
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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ac4r, EXXON COMPANY, U.S.A. <br /> P O Box 4415 Houston TX 77210-4415 <br /> i �i c o a r o s a r ¢ o CHAIN OF CUSTODY <br /> THE ASSUN4NCf Of Til16LITY <br /> Consultant Mame <br /> ❑ Novato,CA Address <br /> 11 Digital Drive,94949 Pnect Contact Jf_ ` Proec:t# — 3 <br /> (415)883-6100 Phone _ Fax# <br /> ❑ Irvine,CA ConsultantWork Release# q!I r <br /> Afton Business Parc <br /> 30 Hughes St , Suite 206, 92718 Exxon ContactPhone# <br /> (714)380-9559 site RAS# :1-3:70$ _ <br />' Site Location of <br /> Laboratory Work Release 1t <br /> Sampled by{please n SOIL WATER <br />' L-1 <br /> Sampler Signature Date Sampled 6 <br /> Sample Collection $ 8 m <br /> t �t � o ai a Remarks <br />' Descnptwri D.�t6fTkne Matrix PISV IC'0001 w w �� wIffw $oI Pw I�w <br /> f/to s y3 <br />' tc) - 10 a.11o S x a»of—1Z3 <br /> M LA.3 a l a <br /> r <br /> 1 �f <br /> Cooler No Relinquished by/Aff illation Accepted by/Affiliation Date Time <br />' cooler seal - <br /> Intact /1 -,� <br /> ❑ Yes <br />' ❑ No <br /> Turnaround Time <br /> (circle Chace) <br />' 24 h , `4 <br /> r U►1 <br /> 72 hr <br /> 96 hr <br />' 5 workday <br /> (standard) <br /> shipment Method Additional Commenis <br /> lyutiT <br /> Shipment Date <br /> Distribution White-Original Yellow-Exxon Pink-Lab - Goldenrod-Consultant FiE io Staff <br />
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