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ARCHIVED REPORTS XR0006584
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 XR0006584
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Entry Properties
Last modified
6/21/2019 9:43:10 AM
Creation date
6/21/2019 9:02:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006584
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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❑885 Jarvis Drive • Morgan Hill, LA 95037 • (408) 776-9600 - FAX (408) 782-6308 <br /> N° 007299 jC819 Striker Ave, Suite 8 , Sacramento, CA 95834 - (916) 921-9600 • FAX (916) 921-0100 <br /> p 404 N Wiget Lane - Walnul Creels, CA 94598 - (925) 988-9600 - FAX (925) 988-9673 <br /> MSCO <br /> ❑ 1455 McDowell Blvd North, Suite D• Petaluma, CA 94954 - (707) 792-1865 • FAX (707) 792-0342 <br /> N ❑ 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 - FAX (650) 232-9612 <br /> m <br /> Consultant Company dpi,- Tosco Engineer P 51e in <br /> Address. D !7 C �' ,, �'' Site#, ( 1 9 Z <br /> CI State Zip Coda Site Address. L L&PLe- <br /> '' c� C C'.9 p �s 70 G Caf} c 6 <br /> Telephone �t; Fax# �_ 04Y30 City, Slate' s'� d�?� d <br /> U <br /> Report To us ,4-,1Skr Sampler QCData, PU Level 0 (Standard) ❑Level C ❑ l eves B ❑Level A ,I <br /> c <br /> Turnaround *10 Werk Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinldng Water Analyses Requested a <br /> Time, 0 2 Work Days ❑ 1 Work Day ❑ 2-6 Flours ❑ Wasle Water <br /> p OlherNyl �ti�o Ked <br /> Project Coding ��o�� <br /> � ` ti <br /> Client <br /> Datel a Matrix 4 of ConSample Q�'�Q,t+� ���o�yo�p��'� Comments <br /> Sample i D Sampled Co e Typ p1e a <br /> t F - ~ g lit I— <br /> svUArr+ r <br /> 2 hu <br /> 0 <br /> 3 <br /> 4 <br /> 5 0 <br /> 6 <br /> } <br /> U 7 <br /> L <br /> Q 13 a <br /> 9 , ch <br /> N 10. <br /> Relinquished By Date 2 l Time `eco n Receives! B Date `Gl Time i"OO 3 <br /> Relinquished By � Date /e ���t Tirrtts �yyA Received BU99Date 01 1 Trmejg1ID <br /> Rehn wished B , Date Time Received B Date Time <br /> i� Were Samples Aecerved In Good Condd+ons ❑ Yes ❑ No Samples on Ice? ❑ Yes ❑ No Method of Shipment Page of � <br /> N <br /> U To be completed upon receipt of repos <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑No if no,what analyses are still needed <br /> 2)Was the report Issued withn the requested turnaround time? ❑Yes ❑ No If no,what was the turnaround time? <br /> Approved Signature Company Date <br />
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