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ARCHIVED REPORTS XR0003741
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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2575
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2900 - Site Mitigation Program
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PR0541989
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ARCHIVED REPORTS XR0003741
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Entry Properties
Last modified
6/21/2019 9:04:10 PM
Creation date
6/21/2019 4:37:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003741
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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SHELL OIL COMPANY CHAIN OF CUS ODY RECORD Dole. <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Sona[ No �} �Q?Zq�sl Pacgo Z of 3 <br /> Silo Address: $�QJo <br /> 2575 Country Club Blvd. , Stockton, CA Analysis Required LAB. A <br /> 1 <br /> 204-7524-3505 CHICK 0111(1)lox ONLY CT/DT TURN AROUND MME <br /> � <br /> ❑ 4411 <br /> Shell Englnoor: Phone No . 510 aw }'°°"° '° 34 houn ❑ <br /> FCl)(7){-3168 3"�Invo�llpolon 4441 41 hours ❑ <br /> Alex Perez _ `� � ❑ <br /> Conbla nl 9'e &Address 9 Sum clouvy/owp°s°1 4442 <br /> sine ecT erv�.ces, Inc. _y ❑ taaarr ❑Trr°,,,,au <br /> 1680 Rogers Ave. San .lost? CA 95112 _ � x T wGivil /pw orh.r <br /> Consullanl Conlacl. Phone No,; 408- y p°`°r ❑ 1A4� O <br /> tl <br /> 573-0555 `� N 0' 1011/Akaem ori <br /> Iran xlti�e o �' w tit %.9p,M y 134413 <br /> iftix N 573-777 o ry Nall I1011tytab u. <br /> Commonls. C� „pp WtA-1 Rom oflys ❑ 4451 .o0n o,r0.,lbl.of <br /> (oo 4 a 1t 34/41 his IAT <br /> w U n Mot <br /> Sampled by; in C4 c �, <br /> `—� to so oS n n 05o UST AGENCY: `?L!7I-i jj''s k�7 <br /> Prinlod Name. ND>Ek nj O n 41 �^ <br /> O= tx ° .0 °- MATERIAL SAMPLE <br /> No of x x .� E CONDITION/ <br /> Sample ID Data Sludge Sall wcrar Air canis ,"_- m y° ,"_' U Q v a �j DESCRIPTION COMMENTS <br /> /4w- 10 X <br /> w- 1z L x X — <br /> ,, <br /> Mw- 13 Z <br /> Yw , x xx S <br /> 1 Do P X (0 — X x <br /> F5 L] <br /> R qUs By slgnatura), Pd ad ma, Dolo C), , Rucelvod (ilgnaluro), Pttnlad 5� Noma[, Dalo `7 1 Time _ » cam---- ,C /] !1'1- 6�1 <br /> 142i <br /> Win _ d By(sl nq] INInlad Noma. Dale °�. d ocalvod (signs ra). Prinlud Name, Da s <br /> Ft f /t/C ,d ai//4fc me — �1 lima <br /> Rollnquhhed By(slgnaluro), Prinlad Homo. Duln Rucolvod (llgnaluro),\ Prinlad Namo. Dale 7 <br /> �„� -nn <br />
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