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ARCHIVED REPORTS XR0006109
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 XR0006109
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Entry Properties
Last modified
6/21/2019 12:55:13 PM
Creation date
6/21/2019 10:35:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006109
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 LLC Lab 530 297 4800 Q 7 <br /> Fax 530 297 4808 Lab No Page of <br /> Project Contact(Hardcopy or PDF To) California EDF Report? El Yes Dd No <br /> G ►� e, �4/we.Ase Chain-of-Custody Record and Analysis Request <br /> Company/Address / - J RecomnwxWbatrwt to t�se� q <br /> ".94�A F Sampling Company Log Code <br /> C Analysis Request <br /> Phone No FAX No Global ID <br /> CO X <br /> fro 6�.2 4 73 - - - o <br /> Projectect N� P p No EDF Deliverable To(Email Address) w C4 LU <br /> o ro m m 3 <br /> 1 <br /> � X C <br /> Project Name Sampler Signat re $ +n m m N a _ 0 <br /> SRni��Zi��� ! ` °0 m C0 c� m Q e <br /> cD Q w q <br /> Protect Address Sampling 2 = a a N W. o f N ro <br /> e��, <br /> -r- CI&I ,B1 c� p 9 Container Prose rve Matrix o C � �12 22y N e, W t � <br /> N N p� r .LL.r M ML. <br /> l+.i ti O Z O W J W C7 rn br v, Vi N m y Q n <br /> Sam le Designation Date Time v u, i 0 °z ¢ 0. Q a 0 0 0 0 a \ <br /> O <br /> \ m m r- r- r I kn ti U3 r- _ w > <br /> �� 2 0 3 is3o 3 <br /> —ar <br /> I <br /> s <br /> Relinquished byD le Time Received by Remarks <br /> �a 3 i7/S <br /> Rel+nqu+shed by Date Time Received by <br /> Relinquished b <br /> q Y Date Time Rete ed by Laboratory ��, Bill to <br /> rz- <br /> Orstnbution White-Lab, Yellow-File Pink-Ongrnator <br /> E Formalcoc 121001 th9 <br />
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