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ARCHIVED REPORTS XR0003350
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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2705
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3500 - Local Oversight Program
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PR0544595
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ARCHIVED REPORTS XR0003350
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Entry Properties
Last modified
6/24/2019 11:38:23 AM
Creation date
6/24/2019 10:55:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003350
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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01riii[y rirrur duvsi . Err�� �p rrom imnlcn state: <br /> Noma <br /> { Alpha alyttcal, Inc AZ CA� NV WA <br /> � `� '� s�in�'vt- l ht- 255 Gle Avenue Suite 21 <br /> Address " _ C� �; !U OR_ OTHER o! <br /> + 4S'U Sparks da 89431 5778 <br /> City,State,Zip ,r1 �M.-e t-- C 14Phone (775)355 1044 <br /> Phone Number "iJ Fax 'a f7 c' Fax (775)355 0406 Analyses Required 683 .3 <br /> Client Name `7 P'3 r1 PO # Job# <br /> � Required QC Level? <br /> Address Entad Address <br /> -70 C1�-;v� -r C��� �lud , 1 11 /it 1V <br /> City State Zip Phone# Fax# <br /> C 'ice[� r '+l <br /> y nal tic �a 0 / DFS YE$` HO <br /> Time Date Matrix` Officemy Sampled by RepodAttenhon r+ -1 � �t~ t[ECeI <br /> Total and type of .t N p <br /> Sampled Sampled See Key Only <br /> goner r <br /> Below Lab ID Number Sample Description TAT Feld <br /> container J A _� _ r r <br /> — Field <br /> "See below ^+� + f—TRKS <br /> NOI Ntw - era re <br /> G <br /> 07 -0:2 MW -7 <br /> fMa M w -� fare <br /> - M10- f * arm <br /> ADDITIONAL INSTRUCTIONS <br /> Sign r Print Name Company Date Time <br /> Relinquish y <br /> Received by <br /> Relinquished by <br /> Received b <br /> CL <br /> Relinq [shed <br /> Received by <br /> "Key AO Aqueous SO Soil WA-Waste OT Other L-Liter Moa S-Soil Jar 0-Orbo T Tedlar $-Brass P Plastic OT Other <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense The report for the analysts <br /> of the above samples is applicable only to those samples received by the laboratory with this coc The liability of the laboratory Is limited to the amount paid for the report <br />
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