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ARCHIVED REPORTS_XR0004431
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3500 - Local Oversight Program
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PR0545347
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ARCHIVED REPORTS_XR0004431
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Entry Properties
Last modified
2/6/2020 5:04:23 PM
Creation date
2/6/2020 3:38:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004431
RECORD_ID
PR0545347
PE
3528
FACILITY_ID
FA0003685
FACILITY_NAME
DBA CIRCLEK, REFUEL PETROLEUM INC.
STREET_NUMBER
419
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21938610
CURRENT_STATUS
02
SITE_LOCATION
419 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
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EHD - Public
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i <br /> Cond Earth Technologies, Inc. 0 _ <br /> CHAI -OF-CUSTODY <br /> ❑ 21653 Brian Lane X 188 Frank West Circle, Suite F <br /> P.O. Box 3905 1 Sonora,California 95370 Stockton,CA 95206 <br /> NO_ 5830 209-532-0361 209-234-0518 <br /> 209-532-0773 (fax) 209-234-0538 (fax) <br /> 1 Cf� ctRX 7T,4 T- info@condorearth.com(e-mail) condor 9condorstockton.com(e-mail) <br /> i <br /> SHIPPED TO: SEND RESULTS TO: <br /> &_Qe3i7 V Ss _ NAME: L �lArsc <br /> - Gc'ns . C A __ OFFICE: ff 1! o <br /> 2,12 <br /> ❑ PLEASE FAX RESULTS: PROJECT. <br /> PROJECT NO. <br /> 3761 NO. J Verification <br /> SAMPLED BY. of <br /> (Signature) '1'0AIA �✓ccon- <br /> fain- <br /> Date Time Sample ID ers a °9 REMARKS: Misc. <br /> 37 - A - 6 1s v oxo .'nc/ rs <br /> 0 3-741- lila.- IsoT <br /> _� <br /> 12. 3741- AW - zx o --T <br /> 0:) 3 7 G 9jo 5TA <br /> 142-0 31 -Xw7- G 24'-103 <br /> TP <br /> ► s�� 3?6- zr o �T <br /> 1110 3791- w - G TMr <br /> M <br /> Relinquished By: / Date: Time: Received By: Date: Time: <br /> (Signature) o,KH ` �� s I :t o (Signature) -T._ e-,e-,/2£/f 0'. ,•/ J <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> (Signature) (Signature) <br /> Relinquished By. Date: Time: Received By: Date. Time: <br /> (Signature) (Signature) <br /> Original-Send Yellow-File Pink-Log Book <br />
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