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COMPLIANCE INFO_2004-2005
Environmental Health - Public
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2575
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2300 - Underground Storage Tank Program
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PR0231070
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COMPLIANCE INFO_2004-2005
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Last modified
1/30/2023 2:30:02 PM
Creation date
6/3/2020 9:43:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2004-2005
RECORD_ID
PR0231070
PE
2351
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231070_2575 COUNTRY CLUB_2004-2005.tif
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EHD - Public
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2795 Second Street,Suite 300 Cal Science Environmental <br /> Davis,CA 95616 7440 Lincoln Way <br /> Lab: 530.297.4800 Garden Grove, CA 92841 <br /> ANALYTICAL LLC Fax: 530.297.4808 714-895-5494 Lab No. Page _]_. of _1_ <br /> Project Contact(Hardcopy or PDF to): Geotracker COELT EDD REPORT? Chain-of-Custody Record and Analysis Request <br /> _YES _X_NO <br /> Company/Address: <br /> Kiff Analytical, LLC Sampling Company Log Code: Analysis Request 11 ® o <br /> Phone No.: FAX No.: Global ID: 0„ <br /> Project Number: P.O.No.: EDF Deliverable to(Email Address): A O <br /> 206-0783-001 40904 -° N o <br /> Project Name: E-mail address: co N co <br /> 2575 Country Club Blvd., Stockton linbox6ftiffanal ical.com 00 2 Q <br /> Project Address: Sampling Container Preservative Matrix W it W > c <br /> N L o L. <br /> Sample y 11 T o o � 00 v az. z <br /> Designation Date Time 0 a dE co i = -0 a z Two=ffiw Q- UI I I <br /> H-1-8.0 11/5/04 3:00 1 X X X X <br /> H-2-8.0 11/5/04 3:10 1 X X X X <br /> T-3-10.0 11/5/04 2:30 1 X X <br /> Relinquished by: Date Time Received by: Remarks: This is a revised COC for Work Order No. 04- <br /> �.�.�-�- 11/11/04 17:20 11-0490, adding TRPH to samples H-1-8.0 <br /> Relinquished by: Date Time Received by: and H-2-8.0; Rush OK by S. Nowak 11/11/04. <br /> Relinquished by: Date Time Received by Laboratory: gill to: <br />
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