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ARCHIVED REPORTS_XR0004443
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3500 - Local Oversight Program
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PR0545347
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ARCHIVED REPORTS_XR0004443
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Entry Properties
Last modified
2/6/2020 4:42:39 PM
Creation date
2/6/2020 3:45:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004443
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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EHD - Public
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• CondA Earth Technologies, Inc. • <br /> CHAIN-OF-CUSTODY ❑ 21663 Brian Lane 188 Frank West Circle, Suite I <br /> C P.O. Box 3905/Sonora, California 95370 Stockton, CA 95206 <br /> Al0 6 37 T <br /> N! 209-532-0361 209-234-0518 <br /> 209-532-0773 (fax) 209-234-0538 (fax) <br /> info@condorearth.com(e-mail) condor@condorstockton.com(e-mail) <br /> SHIPPED TO: SEND RESULTS TO: <br /> ,42.66AJ ZASS NAME: _ <br /> C=L-�S .C-4 OFFICE: S-ie✓C o�,tr 1 <br /> PLEASE FAX RESULTS: PROJECT: L 1 Zowrt: ,376 1 <br /> PROJECT NO. . <br /> J Verification <br /> SAMPLED BY: of <br /> (Signature) con- <br /> tain- <br /> Date Time Sample ID ers REMARKS: MISC. <br /> Jz z� <br /> 13;57 =376ic-in&,2L-j 4 � u A ' <br /> � ;z5 lz z� <br /> 17 :5Cu 7�icr MxJ % <br /> 37416 - /Wk; 7 ~iL <br /> i3'.53 3 71,ie-' •-I'I'lttq '.1 Z' I <br /> 13 `b 37414 <br /> 13 : 4TH 376)c �Al31j !L�a <br /> eFau,!�s'; QOF <br /> A . <br /> Relinquished By: -7 Date: Time: Received By: Date: Time: <br /> (Signature) L L"7 C r�i 5SD (Signature) hovic w/ 6:g .0 <br /> Relinquished By: Date: Time: Received By: Date: Time.- <br /> (Signature) <br /> ime:(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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