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ARCHIVED REPORTS XR0003751
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 XR0003751
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Entry Properties
Last modified
6/21/2019 9:18:29 PM
Creation date
6/21/2019 4:43:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003751
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 CUSTODY RECORD Data: o79-J4n47 <br /> RETAIL ENVIRONMENTAL ENGINEERING - WEST Serlal No: Page of/ <br /> Slla Address; <br /> a575- Cpca2y dub 5ck C Analysis Required LAD: ,se oPa <br /> WIC#. 204- <br /> 7 5a q - 3 5o 5 CNEcIf ONE 111 sax ONLY CUM TURlt AROUND TIMI <br /> Shell Enginaer: Phone No.: 510 <br /> G W Monlorinp ❑ 44+1 24 hours ❑ <br /> gg 1 <br /> jff- - NrAv\b4wy Fax�]5_ 6� T7.t N <br /> o f1 1111 41 hours C1 <br /> Consullanf Name 8f Address: P.O. Box J2�59 '� � cl��.u�rnn�ral Pf Isaoys ��N,,,,�,I► <br /> Envlros Inc . , Sonoma CA 954?6 � � Wcrltyraa�a.o! ❑ +++s �h„ � <br /> Consullan! Confacl: h �p7 _ <br /> Joe Neely P9� e 4 � � � � °° � � 4lFAA41temorSys � 1117 <br /> Fnx : iS -66 I _ 4 to `n WE Nollfy lah nt <br /> CammenlS: Wdor Ram or Sy loan ON/oulblo of <br /> v -d �: VF 501GAM ❑ 416] 241+4 his 1A1 <br /> a a a <br /> W 1 z olhor [I <br /> Sampled by: J N to <br /> g C3 a 0 0 a ; UST AGENCY: <br /> Prinled Name:.1� 1V � a �; m n 0 r n SAMPLE <br /> L d MATERIAL <br /> c CONDITION/ <br /> Sample ID Dain Sludge Sall Wolor Air No °r l=' a a U U DESCRIPTION COMMENTS <br /> cants w > r U <br /> 27 <br /> Ran uUhod By pna uro): Pr Nanta: Dale. JZ9 yRacal d hn (fin Iwo c PL led No a. Data, l-ZCT Q7 <br /> RaUWi&d By( �nahMo). Pclnlod Neano: Dala• Racvod slunalure). PLlnlod Name: Rgls: <br /> ILine _ Ilrne. <br /> RaIlnc�sitad Ay aanaluis). Prinl.d Homo: Dale. ^ RaCetved(d }Lafulo): Pllnled Narno! Dalo ti-�z ,-q7 <br /> ME LABOR&JORY USI lR4YlDE A QQP,y_4E1111S Q11A1H--Of-C011212-Y-W1111 111V IGE AIy[2.RFU1J <br /> nwaa+,w woo, <br /> ■ <br /> h <br />
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