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ARCHIVED REPORTS_XR0011976
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WILSON
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130
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3500 - Local Oversight Program
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PR0545892
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ARCHIVED REPORTS_XR0011976
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Entry Properties
Last modified
7/22/2020 2:53:12 PM
Creation date
7/22/2020 2:25:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011976
RECORD_ID
PR0545892
PE
3528
FACILITY_ID
FA0003601
FACILITY_NAME
ARCO STATION #826951*
STREET_NUMBER
130
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205-5561
APN
15502064
CURRENT_STATUS
02
SITE_LOCATION
130 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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_ Pt oJect Nnme: ARCO 5469 OW Quattorly Un-gate !fire y� lent <br /> bp BPBU/AR Region/E rosSegment: Of'>Ammices>West Conal>Wall>WCBU>CA OffStic Iliac /Q Ielnp <br /> >Northam>5469>fiislalcnl L Sky Condillouv 14 j&1,tq <br /> State of Lead RegulatotyAgency: SenJonquinCountyBnvlrenmanl lMann utantbapt Meleortd+tgfvnl l-velttg <br /> 110(ligted Duo Dnle(tarn/dd/yy): WV4,w 7 +hid S reed Direction <br /> Lab Name Sequoia UWAR lInclilix No' 5469 uniullnttl/t;rtultntint' SUttplg I'm irnnnrenlal,hie <br /> Address 885 Jarvis Drive BPIAR 1 nuMIX Arlrlregq; 130 S. Wilson Wny,Slocklon CA 95205 Aildten: 1110 Contemn I'alk Drive,State 550 <br /> Morgan Ililt,CA 95037 91101,1111,ing NIA - _ t'11itictun Poik CA 95682 <br /> Lab PM Lisa Race Cnfirurnln Ulobnl ID No' 106077011888 _ongnlhrlil/C'uillinelm Ptu}ecl N+r U5469 <br /> tele/Fax 408 776 9600/408 782 6308 1 tiros Project Nu' 0013711.110Uz 011141111anth onlinder!'M by iohnsou <br /> BP/AR PM Contact Paul Su ple Provision or RCOP: Provision I clell lix, 510 676,600U/530 676 6005 <br /> Address P 0 Box 6549 I'hnse/W13S, 04-Moiditamed by Natimil Allentinhon 1(c)1111 1 tc 4%QU bevel' I evel I with HDI' <br /> Moragn,CA 94570 Sub Tinsel I nsk 03-Ann1 iicitl 1.-111111)I'U11 1 o, Detdte Yuc R 1114cul 7 eom <br /> TeleTax 925 299 88911925 299 8872 'osi r fenlent 05-Subwolracled Costs 11111yoke Io' lltlttuflc Itivhllelt tau <br /> Lab Bottle Otdei No fllnlrix 1'l egetvnfiv0 lieyttestfidAuulyRle <br /> u <br /> No Svnple Desci 1ptfun Q l.nhut 111111 y No. u° nntlrle Point Lnt/Lung and <br /> o Q ° <br /> �, i,.., a comments <br /> u o p O <br /> a z <br /> x` <br /> 17 UYY&7JVFz bdJL <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 j <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> id <br /> Sampler's Name ML 1 q hed 1 1i vn Dnic 'I lure Avee 1!011 II'f Alfillallun Date Ti— <br /> or!er's Cont au .�w► l.g plk <br /> Shipment Date $L7'S d -r <br /> Sh�ment Method &*- <br /> Sh1 meat 1 racking No <br /> S ecrallnstructions <br /> Custody Se Place Yes No Temp Blank Yes No Cooler'I'eutlterrltute on Receipt ) IC I ri t kllatik YeAlc <br /> Distrihu ton While Copy-Labointory/Yellow Copy- 13P/A1lanfic Riclrf cki Co, 1 Ptn Copy-ConstillaiiUCouirnctor 1111 C OU up, 4 1011104 <br />
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