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ARCHIVED REPORTS XR0005965
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 XR0005965
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Last modified
6/21/2019 2:53:44 PM
Creation date
6/21/2019 11:09:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005965
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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ALOIA ANALYTICAL ❑ 680 Chesap*Ke Drive o Redwood City, CA 94063 • (415) 364-9600 FAX(415) 4-9233 <br /> ❑ 819 West Striker Ave. • Sacramento CA 95834 - (916) 921-9600 - <br /> FAX (816) 921 0100 <br /> CHAIN OF CUSTODY ❑ 1900 Bates Ave., Suite LM - Concord, CA 94520 - (510) 686-9600 FAX(510) 686-M9 <br /> Company Name: �t V� L`` x Project Name: <br /> �,�,•� �. , r S <br /> Address: Vic, k C 2- Billing Address ( if different): <br /> City: j State: $ Zip Code: 4 5 z,, <br /> Telephone: IL ER-- T7?_Z �L� P , P.O. #: <br /> Ll <br /> U <br /> Report To: JSampler: QC Data: 1A Level A(standard) ❑ Level B ❑ Level C ❑ Level D ' <br /> Turnaround-;&10 Working Days a 3 Working Days ❑ 2 - 8 Hours ❑ Drinking Water JAnalyses Re nested <br /> Time: ❑ 7 Working Days ❑ 2 Working Days CJS Waste Water icy <br /> Cz 5 Working Days ❑ 24 Hours ❑ Other <br /> Client DateMme Matrix #of Cont. Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample# '�� �'' �,�b Comments <br /> CC <br /> - m <br /> 4. <br /> 5.CR-1 15--16 _ 0q <br /> 6.GQ- � <br /> 7. Lip_z 3s -3? � TJ <br /> 'o <br /> Cr <br /> 8. <br /> 9. <br /> 10.x* P-3 _0�? <br /> Relinquished By: Dater! Time:G,'Rl Received By: Date: Time: <br /> Relinquished By: Date: Time: Received By: Date: rime: <br /> Relinquished By: Date: Time: Received B Lab' " time: I�O <br /> Were Samples Received in Good Condition? Yes 0 No Samples on Ice? A Yes ❑ No Method of Shipment �L 1 civ T— pgge of _2- <br />
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