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ARCHIVED REPORTS_XR0004456
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3500 - Local Oversight Program
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PR0545347
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ARCHIVED REPORTS_XR0004456
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Entry Properties
Last modified
2/6/2020 4:55:14 PM
Creation date
2/6/2020 3:55:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004456
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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I t i i # # C C # t # <br /> � W <br /> HFWHF, INC. <br /> Post Office Box 427 <br /> Oakdale,CA 95361 <br /> CHAIN OF CUSTODY RECORD (209)848-4280 <br /> Project Name: 5 UJ <br /> C�„ � Number �a <br /> Samplers(signature): r <br /> of REMARKS <br /> Containers <br /> Number Date Time U Station Location <br /> g3oVi q30 W.&,"'n we/w <br /> tom- a!c V3&• 1 X i�Dr <br /> Mw-�vlwAno x lmon,,64 �, - �+ <br /> Sctmp <br /> 1e3 ke1) -4 W1tF „YAwl wt, <br /> �� to <br /> Relinquished by(si aiuref Date 1 Time Re (stgna Relinquished by(signature): Date ! Time Received by(signature): <br /> Company e y'. Comp or Agency: Company or Agency: Company or Agency: <br /> w /C . .3L.) & cc <br /> Re' u ed by(sig Date 1 Time Recei a by(signatur Rekinquished by(signature): Date ! Time Received by(signature): <br /> Com r gency: Company or Agency: Company or Agency: Company or Agency: <br /> 5 CL <br /> Relinq ished by(sig lure); Date ! Time Received by(signature): Date 1 Time Remarks/Shipping Information <br /> Company or Agency: Company or Agency: <br />
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