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ARCHIVED REPORTS_XR0004445
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3500 - Local Oversight Program
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PR0545347
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ARCHIVED REPORTS_XR0004445
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Entry Properties
Last modified
2/6/2020 5:43:13 PM
Creation date
2/6/2020 3:47:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004445
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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Cond(* Earth Technologies, Inc. <br /> CHAIN-OF-CUSTODY ❑ 21663 Brian Lane 188 Frank West Circle, Suite I <br /> �� 2 P.O. Box 3905 /Sonora, California 95370 Stockton, CA 95206 <br /> 209-532-0361 209-234-0518 <br /> t r—dfa` I /"5 -T 4—T [� nor--, 209-532-0773 (fax) 209-234-0538 (fax) <br /> `7 info@condorearth.com(e-mail) condor@condorstockton.com(e-mail) <br /> SHIPPED TQ. SEND RESULTS TO: Lee- <br /> Nr qo!!� ' &AQ NAME: �. - -- <br /> __,r .r���F OFFICE: <br /> ❑ PLEASE FAX RESULTS: PROJECT: `5:)10k 12nIt ,k u: �ecra <br /> PROJECT NO. . �� ✓ Verification <br /> r`7b� NO. <br /> SAMPLED BY: of <br /> con- <br /> (Signature) twin- P ' <br /> Date Tilne Sample ID ers REMARKS: MISC. <br /> z- <br /> llt 376( - L0p (7 n <br /> z,q -1-17 6.1.- M W V-11 z o - 10-714 <br /> 16 l 6 -6a 6- <br /> 106 76 - A11V -6 z o - a � <br /> IL <br /> i 37Gf - rv�-6 _ gTA <br /> lgw't 611,q I nY <br /> 10A AlwIe - 6 12W 1 n <br /> �16l- �11- 6 nq <br /> Relinquished Date: Time: Received By: D te: Time: <br /> (Signature) ,� c�,,.r p L{' (Signature) - LS 04 ' <br /> Relinquished By: Dat : Time: Received By: Hate: 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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