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ARCHIVED REPORTS XR0006665
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 XR0006665
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Entry Properties
Last modified
6/21/2019 10:07:08 AM
Creation date
6/21/2019 9:22:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006665
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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BC t_A80RATORIES INC SAMPLE RECEIPT FORM flet No 10 01/21104 Page _ Ot <br /> Submisslon #_ �j — Project Code TB Batch # <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express ❑ UP'S l7 Hand Delivery ❑ Ice Chest L( None U <br /> BC Lab rleld Service a Other El ISpecltyl Box ❑ Other ❑ (Specify)� <br /> Refrigerant ice Blue Ice ❑ None ❑ Other ❑ Comments <br /> Custody Seals Ice Chest ❑ Containers ❑ Nonell'Comments <br /> Intact Yes 0 No U Intact> yes Q No <br /> AN samples received" Yes f'! No 0 All samples containers Intact Yes No❑ Descnption(s) match COC? Yes C�—�* ❑ <br /> OC Received Ice Chest ID Wm Emissrvlly _Q_�_`� Date/Tune �C7 <br /> IYS ❑ NO Temperature �_ •C Container <br /> LLJJ ID, Analyst Ina <br /> SAMPLE CONTAINEAS i 2 4 5 s 7 e 9 10 <br /> OT GENERAL MiNERALI GENERAL P"YSICAL <br /> PT PE UNPRES€RUED <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> Ioi_NITRATE I NITRITE <br /> 100m1 TOTAL ORGANIC CARBON <br /> T TOX <br /> PT CHEMICAL 0XYGEN DEMAND <br /> PIA PHENOLICS <br /> 40ml VOA VIAL TRAVEL BLANK <br /> 40ml VOA VIAL 3+ <br /> T EPA 4f3 l 41] Z.418.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL W <br /> 40 ml VOA VIAL 504 <br /> T EPA 5081608AQ80 <br /> T EPA 515 118150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> I00nn EPA 547 <br /> 100ml EPA 531 1 <br /> T EPA 548 <br /> T EPA 549 <br /> "t'EPA 632 FRIBUTQN- <br /> UT EPA"I SAI <br /> T A C <br /> T AMBER <br /> I OZ JAR <br /> U Ol_JAR <br /> TOILSI EF VE <br /> PCB VIA <br /> 'LAST IC BAG <br /> -ERROUS IRON <br /> ENCORE <br /> nmmen t s <br /> ample Numbering Completed 13y OaielTime <br /> IFI%00CS1WP80VLN6 0OCSIr0nn!$15AMAFC2 WPt <br />
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