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ARCHIVED REPORTS XR0003465
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 XR0003465
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Entry Properties
Last modified
6/24/2019 12:59:12 PM
Creation date
6/24/2019 11:24:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003465
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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i <br /> EXXON COMPANY, U.S.A. <br /> P O Box 4415,tk"10n,TX 77214-4415 <br /> pace't° ° top ° R � TCHAIN OF CUSTODY <br /> THE ASSURANCE Of OUALITT <br /> Consultant!Jame De <br /> wvato,CA Address 3-3 3 o <br /> 11 Digital Drive,94949 ProlectContac 0- Pro4 n Q <br /> (415)883-6100 Phone r!16 46" 3 $S Fax#CQ/6) 63 5re3 V S- <br /> ❑0 <br /> Irvine,CA Consultant work Release II <br /> Alton Business Park , <br /> 30 Hughes St ,SUde 206,92718 Exxon ContactPhone -� <br /> (714)380-9559 Site RAs at' -'1 v FT <br /> Sate Location �.�r� �,�,-�� �,5 p ✓ <br /> Laboratory work Release <br /> Samby(Please Plant) SOIL WATER <br /> Sampler nat" Date Sampled 61 6 <br /> Sample Collection all of $ �� �� $ $2 �2 Remarks <br /> Description �ale/Time Matnx Pmv Cont {a a Q= -9 0. w Q w ami <br /> �w w do -w <br /> - i IS-1 t 1-3574-5 <br /> W-2 #a r:,r-f 1+J 3 75. 3 <br /> LZ.-+ - i <br /> v� w- tl;.Gs <br /> q! <br /> Cooler No Relinquished by/Affiliation Accepted by/Affiliation Date Time <br /> coder seal <br /> Intact <br /> o Yes , -- 1� L c /z_ 16-5, IV 2 3 <br /> Turnaround Tame r <br /> (circle choice) <br /> 24 hr o <br /> 48 hr <br /> 72 hr <br /> AdA Ale, <br /> r <br /> 5 wo da <br /> tandard <br /> Shipment Method Additional Comments <br /> ipment Date <br /> Distribution White-Onginal Yellow-Exxon Pink-Lab Goldenrod-Consultant Field Staff <br />
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