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SERVICE REQUEST <br /> Facility ID Facility Name 275 E. G TLINE, TRACY <br /> Record ID 01495_8 Location <br /> Property Owner JOHN PESTANA Q TIP TRUST <br /> Business Name C/O GERALD ,:SPERRY, ATTORNEY <br /> Street Number Dir Street Name Type Unit <br /> PO BOX 672 <br /> 2nd Address 1818 GRAND . CANAL, STOCKTON <br /> City MANTECA State CA Zip 95336- <br /> Phone 1 209-239-5033 Ext APN 214-320-80 <br /> Phone 2 209-838-9888 Ext <br /> Census 000001 District 005 Location 02 Cityco':de <br /> Requestor JOHN P. LANE, RG, GRND ZERO <br /> Business Name V & W DRILL, C-57 #720904 <br /> Address I PO BOX 51 <br /> Address 2 <br /> City RIO VISTA, : State CA Zip 94511- <br /> Phone Number 707-374-2815 Ext <br /> Nature of Service Request - <br /> MONITORING WELL (ALL:� 3) DESTRUCTION PERMIT VIA PRESSURE GROUT, <br /> SITE HAS RECEIVED "NFA" FROM EHD AND CONCURRENCE FORM CVRWQCB, <br /> SERVICE REQUEST <br /> Comments <br /> THIS WILL CLOSE SITE SINCE NO POST-REMEDIAL MONITORING REQUIRED. <br /> GROUND ZERO CONSULTINGnCHECK #008159 DEPOSITED FOR THIS PERMIT. WORK <br /> PLAN APPROVED BY MINFURNA, LOP . <br /> Name;�r - Date Time <br /> Received By 0684 INFURNA, ' MICHAE 03/03/98 <br /> Assigned To 0684 INFURNA, ; MICHAE 03/04/98 <br /> Date,- Service Completed Requires Further Action Y/Ni Y <br /> Amount paid 60 . 00 Program/Element 3502 <br /> Due date <br /> OaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaadddggG <br /> 0 This record was entered on 03/04/98 By STAFF 0 <br /> This record was last updated on 03/04/98 By STAFF 0 <br /> - -- - - - - - - - - - - - - - - - - - - - - - -- - <br /> aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaai <br /> 4L <br />