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ARCHIVED REPORTS XR0000399
Environmental Health - Public
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EHD Program Facility Records by Street Name
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B
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BENJAMIN HOLT
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2905
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3500 - Local Oversight Program
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PR0544110
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ARCHIVED REPORTS XR0000399
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Entry Properties
Last modified
2/7/2019 10:55:19 AM
Creation date
2/7/2019 8:58:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000399
RECORD_ID
PR0544110
PE
3528
FACILITY_ID
FA0003712
FACILITY_NAME
CHEVRON STATION #94275*
STREET_NUMBER
2905
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09760004
CURRENT_STATUS
02
SITE_LOCATION
2905 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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• 17J [JOJA AINA 1�+lL.l�M 1]13�1Y� LIP',l�l`iCEI T LOG <br /> CIXEN'1`NAME— DA.TJr PEC'T!1tT LAI) (/ ]IL inkiug water for <br /> RRC BY(PRLNT) 77 KIT]IIFC'D AT LAD regulatory purposes, YBS <br /> WORKORDTR: 1)ATE L0GCEDTNT: i b _.._ Vaskwsterfor , <br /> regulatory purposes: /NO <br /> CIRCi.E THE APPROPWAM RF 9PO M, LAB DASIf C%TmgT M CONTAIN ER PIMSER SAMILY DATI REAW(KS: <br /> SA14R'L>y # DPSCRIP'i,`.ON VATIVE AIA,TIld SA149i'Y.ED CGNDFTION(ETC) <br /> I Custody Seal(c) Pfesent sciff <br /> s Intsct/Broken*' <br /> 2.Chain-of-Custod rese /Absent* O <br /> 3, Ira is Reports or Ad <br /> PaGkrr I.isf- Pr+cscrttlA sat Q� - <br /> 4.AIrbftl AirbRI/Sticker <br /> riesmi LdjgjRd - <br /> 5 Airb1111l: — <br /> S.Sate to Labels: s"?J hb9cnt <br /> 7 SautpleB)s C j isle I�Tot L#stcd <br /> on Chain-of-Custody PI ... <br /> 8.Sample Condit on'. �lIkoken*! <br /> P* —I <br /> 9. Does iaformatron an t= <br /> custody reports,traffic AA FAI 4= <br /> I <br /> IePOAS and S81t11110 <br /> labou A TC? CS d* <br /> 10 Sample received within — <br /> hold time es o* <br /> 11 Proper 1?[esersratiVC-9 +fA I <br /> used N0* ----- - <br /> 12 TeTnp Roe atLab , <br /> Is temp 4+12°C7 es hu*� <br /> (A"Tiance range for samples rrgn�ng llxec>I pies} <br /> 0-Paception(if esty)' Metals / J)FF ptrwrsom n.dd) <br /> or ProbtsmCOC <br /> *jy Cm c= GO iTACr PROD CT MANAGER AND ATTACII RECORD Oi:MOLUTXON. <br /> sainple Recuo Lag _ - <br /> Revf4lon 3(03118x03) <br /> Replaces Revision 2.3(VINJ02) Page of—j— <br /> Etfechve <br /> "I W03 <br />
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