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ARCHIVED REPORTS XR0006096
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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1876
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2900 - Site Mitigation Program
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PR0542421
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ARCHIVED REPORTS XR0006096
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Entry Properties
Last modified
6/21/2019 1:49:12 PM
Creation date
6/21/2019 10:28:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006096
RECORD_ID
PR0542421
PE
2950
FACILITY_ID
FA0024377
FACILITY_NAME
COUNTRY CLUB BLVD/295950
STREET_NUMBER
1876
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12319101
CURRENT_STATUS
01
SITE_LOCATION
1876 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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2795 2nd Street,Suite 300 <br /> .�� Davis,CA 95616 <br /> ANALYTICAL zcc <br /> Lab 530 297 4800 <br /> Fax 530 297 4808 Lab N Page or r <br /> Project Contact(Hardcopy or PDF To) California EDF Report? Cl Yes MNo } <br /> Gce,t c .,t <br /> 60,Vv Se, Chain-of-Custody Record and Analysis Request <br /> Company/ rens / / , b„r b <br /> A'4&0114-11 Sampling Company Log Code <br /> 4'1�56L-- Iserex y .A Cd I xzu I Analysis Request <br /> Phone No FAX No Global ID m <br /> KIn.1vg•S3t0 Sao 44a dA73 m m 0 <br /> Project Number P Q No $ N CO <br /> EDF Deliverable To mail Address X X� m <br /> LV G��tb E �I NL7 `m o u! lil w ry x A <br /> Project Name Sa pier 5rgnature R u+ m ~ � `� < � � <br /> w � W � .8 LU i <br /> m m w a <br /> Project Address <br /> Cd <br /> 5sMatrilm am c Cw 1sq vN aL~ go <br /> Sampling Container renS <br /> N <br /> Q <br /> r <br /> �+.T—E <br /> IQ <br /> CT ZO C <br /> Date Timezz °Sam l@ Designation m oO <br /> Ln <br /> rJ� �� ��3 1 ✓ t/ 01 <br /> 0� <br /> I <br /> l _ <br /> Relinquished by t] to Time Received by <br /> Remarks <br /> �� _ �5 �ydb / sa.•���. �►s �°I�CEPR I<o /}�9p�e <br /> i Relinquished by Date Time Received by <br /> a7�7,4]` �.�S Rr4.vc.�� Coic do✓9P <br /> Relinquished by Dale T ece by Loboralory Bill to <br /> lhsrntrudfon While Lab Yellow-File,Pink-Ongmalor <br /> Forrnslcoc 121 X01 Hl9 <br />
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