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ARCHIVED REPORTS_XR0006295
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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6633
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2900 - Site Mitigation Program
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PR0528433
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ARCHIVED REPORTS_XR0006295
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Entry Properties
Last modified
4/7/2020 1:00:17 PM
Creation date
4/3/2020 4:08:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006295
RECORD_ID
PR0528433
PE
2957
FACILITY_ID
FA0019174
FACILITY_NAME
CHEVRON SERVICE STATION 9-6171
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741048
CURRENT_STATUS
02
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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t-A3; tnpy l_ MoD meport ana to unevron uont.ac a IVU %V u r VI -'"l, SIVu — Ut1VI u <br /> Chevron Facility Number Chevron Contact (Name) {2 c>~ r <br /> Faafilty Addroee G aA v r PT (Phone) <br /> Chevron U.S.A. Inc. _ <br /> P �. BOX 5004 Consultant Project Number �� r Laboratory Name F <br /> Consultant Nome I e r re, +="J if S%^t 'l r, q rv,�eLaboratory Release Number 9 <br /> San Ramon, CA 94583 <br /> Address r Samples Collected by (Name) e <br /> FAX (415)842-9591 a }}t ^ q 3 <br /> Project Contact (Name)_ 1 I- r I L` :n Collection Cate <br /> (Phone) 'V))U"Z"Fnx Number) Z 0 11 y'� ? Stgnoture L <br /> Analyses To Se Performed N()+e <br /> ° <br /> z So <br /> 3 EL 74 o <br /> a a «- �'f3 <br /> E a 5 1 A ° E a 3: °u� �$ N o <br /> �iz' 1031Cr F _ °"° �.. `� `. a.. �`. c`( ftemarite <br /> t <br /> r T3-�!3 3 1.� C <br /> w _ <br /> - <br /> w` � <br /> 11 r� ' <br /> Relinquished By (Signature) Organization Date/71me14-00 Received By (Signature) Organization Date/Time f Tum Around Time (Circle Choloe) <br /> J, S(—:�-S 1. 217- 13 '.J'ep� C9- �L `� - 24 Hrs <br /> Ref qulahed By (Slgn tura) Orgonlzatlon Date/Tlme)7.2D Received By (Signature) Organization Date/Time I51;Days M Hes /► <br /> '" 1 U <br /> Rellnqulshsd By (Signature) organization Date/Time sued For Lab cry (Signature) pate/TTme 1 antraoted <br />
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