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ARCHIVED REPORTS_XR0008425
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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4344
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2900 - Site Mitigation Program
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PR0541976
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ARCHIVED REPORTS_XR0008425
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Entry Properties
Last modified
10/10/2020 10:25:58 PM
Creation date
7/9/2020 9:37:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008425
RECORD_ID
PR0541976
PE
2960
FACILITY_ID
FA0024090
FACILITY_NAME
CHEVRON FACILITY #9-9840
STREET_NUMBER
4344
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
10102157
CURRENT_STATUS
01
SITE_LOCATION
4344 WATERLOO RD
P_LOCATION
01
QC Status
Approved
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LSauers
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EHD - Public
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) Akpy of Lab Report and COC to Chevron Ontact. ❑ NoJ <br /> Chaff —o —C od -- eco <br /> Chevron Foclllly I#umber__9<-9 ._., Chevron Contact (llama)BRETT HUNTER <br /> rP <br /> evron Praducis Co, ioell!!y Addraee 4�W to loo Rd Stockton (Phone)(925) 842-8695 <br /> 0, BOX 6004 Consultant Project Numbar "Z SE ❑DIAlaboratory Name Qn Ramon, CA 94583 Consultant Ilam• BLAINE TECH SERVICES INC. <br /> Address 1680 ROGERS AVE. , SAN JOSE taborolory Service order -911�41�$8 <br /> FAX (925)842-8370 Laboratory Senrtce Cade 02800 <br /> Profacl Contact (Mame) CHRISTINE LILLIE 5omplee Callealed by (Name) <br /> (Phone) 408--573-0555 408-573-7771 <br /> (Fax Number) Slgnature <br /> State Method. ❑ CA ❑ OR ❑ WA ❑ W Series ❑ CO ❑ UT Remarks <br /> a <br /> ++ <br /> I ++ _ O Q <br /> ^ <br /> tr <br /> OR <br /> Mw�r � WLl ��O, � � Lab Sample Ila <br /> Mw.z /oyo X ffG�l <br /> fl-� <br /> _ 1 x <br /> �- - <br /> IL <br /> m Rdlnqulehed By (St lure) OrganIzallon <br /> :i <br /> Date !me <br /> Recely d By (Slgnature) Or antzallon Date e Iced Y/11 <br /> 6 � ? <br /> Turn Around Time (Circle Choice) <br /> s <br /> { <br /> sling ul ed 6y (Signature) Organization Date/Time Recelved By (Slgnoture) Organlzallan Dole/Time Iced_ 2/ tiro <br /> ' / �B Fln <br /> i <br /> _ 3 Days <br /> Aelingulshed By (Signature) Organtrallon Dole/Time Racleved Faraboralo SI 10 Da s <br /> F ry By ( 9nalure) Dals/n • Iced Y/tl <br /> ,•�i�2/11�t� f//�9y roe Conlraclad I <br />
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