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ARCHIVED REPORTS XR0003442
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 XR0003442
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Entry Properties
Last modified
6/24/2019 12:11:34 PM
Creation date
6/24/2019 11:13:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003442
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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0 0 0 <br /> •�1 so,u°IeA,ar,ncal EXXON COMPANY, U.S.A. <br /> 680 Chesapeake Or <br /> Redwood City,CA 94088 F O Box 216x,Houston,77i 771102-7426 <br /> 1415);364 9600 • FAX(4151364-9233 CHAIN OF CUSTODY <br /> Consultant's Name Page of <br /> Addi P Site Location- <br /> s Project fit. Consultant Project tJ: p _ D ConsultarN Work ReleaseDM <br /> N Projaot Contact, Phone# — (, Laboratory Work Release,#- C <br /> 0 EXXON Contact: ,fa Phone#_ EXXON RAS#: �. 3 b U <br /> Sampled by(print) s - vevv Am Sampler's Slgnature: <br /> Shipment Method k L Air Bill #: <br /> TAT: I)24 hr ❑48 hr Q 72 hr d 96 hr NLStandard(lo day) ANALYSIS REQUIRED <br /> Sample Collection Collectlon Matrix #of Sequola's TPH/Gas TPK <br /> TH Tompamiurs <br /> Dale Time SpIWater/Atr Prsv BTEX/ Diesel SM <br /> Descnpflon Cont Sample <br /> 80115/ EPA 5520 Inbound Sal Yee No <br /> 18020 8015 QuftundSail Yes No <br /> N <br /> 7 <br /> Cr <br /> -5� i V, } <br /> ref vw3 "� t ! 2 <br /> 7415-13 f 3'. 10 <br /> T—Agww4l Vol G 5 7� 15.,ao <br /> �m�3Vly 4-511Cr <br /> gf ue Ait k o <br /> tr <br /> �. <br /> RELINQUISHED BY/AFFlLl.4TIQN hate Time CC PTSD//IFFJLlATION Date TJma Addiffam]Co nwnrr <br /> Q� <br /> ��G�rol � & r-7 `030all 10 <br /> ze <br />
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