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ARCHIVED REPORTS XR0006566
Environmental Health - Public
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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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1403
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2900 - Site Mitigation Program
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PR0505513
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ARCHIVED REPORTS XR0006566
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Entry Properties
Last modified
6/21/2019 9:36:54 AM
Creation date
6/21/2019 9:00:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006566
RECORD_ID
PR0505513
PE
2950
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
02
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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"T '5 St V p <br /> ,atB.P. ®IL OMPANY N° ,8 <br /> 5 <br /> 16400 Southcenter Parkway, Suite 301, Tukwila, WA 98188 <br /> i M c 0 A P O R A T E c ►� ,/ CHAIN OF CUSTODY <br /> 7RF ASSURAR[E OF QURIITY `�/� <br /> Novato, CA, 11 Digital Drive, 94949 ❑ Huntington Beach, CA, 5702 Bolsa Avenue, 92644 <br /> Phone: (415)_ 883-6100 Fax: 415 883-2673 Phone: 714 892-2565 Fax: 714 8904032 <br /> Consultant's Name: �t S Consultant Project#: Pae f of I <br /> Address: 1777 Oqlelaml &Zvly S r-E Z CYC <br /> Project Contact: g A-6 N A, C 1E Phone#: S/1) -Z 9 Fax 11:.5/O Consultant Work Order#: 16 -07 <br /> 3 7 <br /> Sampled by (print): A.K1 1 VV.C Sampler's Signature: t.t B.P. Site Location#: III + 2— <br /> Shipment <br /> Shi ment Method: Airbill #: Shi ment Date: B.P. Site Location: Z]TDCk M" <br /> TAT: ❑ 24 hr ❑ 48 hr ❑ 72 hr Standard(10 day) ANALYSIS REQUIRED Sample Condition as Received <br /> Temperature°C: <br /> o Cooler#: <br /> Ho inbound Seal Yes No <br /> 0 <br /> Outbound Seal Yes No <br /> Sample Description Collection Matrix Prsv q of PACE 0 0 e 00 x <br /> Date/Time Soilfwater Cont Sample# > p COMMENTS <br /> 00 <br /> UV-5 3�t, 5 <br /> 1-it) .2- <br /> - 4� t81.('0 <br /> X11 - 7 17ss act <br /> C- 2 06 /Z. <br /> Relinquished by/Affiliation Date Time Accepted by/Affiliation Date Time Additional Comments: <br /> r643 <br /> 12,D7Z6�2 07 <br /> Distribution: White-Original Yellow-B.P. Oil Pink-Lab Goldenrod-Consultant Field Staff <br />
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