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SU0012952 SSCRPT
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SU0012952 SSCRPT
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Entry Properties
Last modified
1/27/2020 10:03:22 AM
Creation date
9/4/2019 11:45:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0012952
PE
2626
FACILITY_NAME
UP-7-95
STREET_NUMBER
2705
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204-
APN
12308029
ENTERED_DATE
1/16/2020 12:00:00 AM
SITE_LOCATION
2705 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\2103\SSC RPT.PDF
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EHD - Public
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r cr or I )or' nd - 7L Cf. - . .-on ��n�l�...: L . .o �r'1gtt1'-'01 --1.L1STOd --record <br /> Chevron Facillt Number 9-4054 Chevron Contact (Home) <br /> y Brett Hunter <br /> Chevron U.S.A. Inc. <br /> Faorllly Address _ 2103 Coun_try Club Blvd. , Stockton, CA (510) 842-8695 <br /> �l •-� �- `-- (then.) <br /> P.O. BOX 500+ Consultant Profact. Number g3'otro• Laboratory tlgmo Serlllnicl <br /> Consultant Homo ' Blaine 'tech Services, Inc. 9033843 <br /> San Ramon, � 94583 Laboratory Rol•ae• Humber . <br /> FAX (415)842-9591 Addro•s 1680 Rogers Ave.-,- San .Tose, CA 951.12 _ ' / <br /> Samploa Collected by (llama) ��`4 Ve r <br /> • Prafocl Contact (Homo) gran Thie <br /> 408-573--0555 ' 408-,573-7771 Callootlon pato 7 to S <br /> (Phone) (Fo)t lrumb•r) Signature <br /> ►p Malyeae 7o Be Performed <br /> DO NOT BILL <br /> .t FOR TB—LB <br /> _ 02�1I <br /> • r- VUO 0. `i. V a • ry <br /> m 1 7 * l; •1- .-• •Y,. .nom .. <br /> L-(L1}l 11 L fT l 1 �: �• p v? V` a. a <br /> r{ ={ I1=0 t. 5r r �,� Q lnr� 1 ni n o `l a <br /> x �N� -'' iii...' (..•" ;,�' �"-' �v .._ � .... n•� <br /> Romork+ <br /> Mw � l d� 3 w ►�:3� �1ct. �� ,c <br /> ,,.,�,�• tj l}¢ i3:3 x <br /> rnw• � 0 11••1•� ,� :. <br /> }o'.5,z <br /> ------------ <br /> I <br /> rllnqurrh•d Dy (Signature) Orgo Izatlgn Dote�llMe r 1{•ooly Ily {S1Qn • OrQanlzallon Doto Imo <br /> � , 3 � /7 /4'� Turn Around Time (circle CAoio•) <br /> •P U6�� � � <br /> %ll2� Hn. <br /> nquls?1 Dy (Slgna1. •) organization DatsAmo nocolyad.n (signature)rL/ Y ( p ) organization Dole/ilma 48 Hn. <br /> s nays <br /> dshad Dy (Slpnalun) Vw"t- <br /> Orgonhotton Dal•xnm' a lleclwecl For or to IT lU DoYe <br /> ry (• nature) Dole <br /> /lime <br /> q� M Canlraoled <br /> L Z(I2f7� <br />
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