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ARCHIVED REPORTS XR0005959
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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2081
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3500 - Local Oversight Program
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PR0544590
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ARCHIVED REPORTS XR0005959
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Entry Properties
Last modified
6/21/2019 4:00:07 PM
Creation date
6/21/2019 11:04:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005959
RECORD_ID
PR0544590
PE
3528
FACILITY_ID
FA0003932
FACILITY_NAME
KWIKEE FOODS
STREET_NUMBER
2081
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12315225
CURRENT_STATUS
02
SITE_LOCATION
2081 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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�r OOJ Jei[V15 Ui1V iviurgan nni, UA `VOU6/ o (4Ub) //b-JbUU ° FAX (4U8) 782-6308 <br /> QUOIA ANALYTICAL ❑ 819 Striker Av ite 8 � Sacramento CA 95834 - (916) 921-9600 FAX (916) 9210 <br /> a- * C]404 N.Wiget La e -Walnut Creek, CA 94598 - (925) 988-9600 FAX (925) 988-9673 <br /> i CHAIN OF CUSTODY U 1455 McDowell Blvd. North, Suite D o Petaluma, CA 94954 0 (707) 792-1865 FAX (707) 792-0342, <br /> ❑ 1551 Industrial Road a San Carlos, CA 94070 o (650) 232-9600 FAX (650) 232-9612 <br /> Company Name: ;{ b � Project Name: <br /> Mailing Address: ` Billing Address (if different): <br /> City: , State: C� Zip Coders <br /> Telephone- FAX #: P.O. #: �-i�a <br /> p Zc� — 2 —3O >= <br /> T <br /> Report To: &V--, Sampler: � � QC Data: P-Level D (Standard) 0 Level C 0 Level B ❑ Level A U <br /> Turnaround 10 Working Days D 3 Working Days ❑2 S Hours U Drinking Water ! Analyses Requested <br /> Time: ❑ 7 Working Days ©2 Working Days U Waste Water o_ <br /> U 5 Working Days O 24 Hours 0 Other <br /> Client DatelTime Matrix # of Cont. Sequoia's <br /> Sample [D. Sampled Desc, Cont. Type Sample # � <br /> Comments <br /> 1. j.�l E-0-� <br /> .o <br /> 2. <br /> (D <br /> m <br /> 3 r <br /> 0 <br /> 4.5. <br /> 6 <br /> 7. 2— <br /> Kco <br /> .o <br /> s. <br /> 9. ' <br /> 10. <br /> Relinquished By: 6. '�V� Date:. Time: C/ Cb Received Timer[6o <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Woo,?. Saiz pies Received in Good Condition? U Yes U No Samples on Ice? .i Yes CJ No Method of Shipment Page of <br />
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