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rajj <br />PHI JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIYk„r+�N <br />LOP PROGRAM - MFR INPUT FORM 1' <br />`APR 2 5 1994 <br />UPDATE <br />(JBY <br />rn Yy i <br />REVIEWED BY <br />DATE ENFIERE6I <br />��� <br />BY <br />PRIORITY <br />RP SEARCH <br />NOR SENTfj <br />b4o <br />_ <br />LOC CODE <br />Gj� <br />4 <br />�., +q ADDITION EDIT: i3 <br />ENTERED LOP <br />39000 <br />SJ/PHS CONTACT <br />M <br />2�(p(p�q <br />} <br />PRIORITY <br />RP SEARCH <br />NOR SENTfj <br />b4o <br />_ <br />LOC CODE <br />Gj� <br />SOURCE OF FUNDS <br />S / <br />0`G A�IIELEMENT CODE <br />3C,1---7- <br />SITE SPECIFIC QUARTERLY REPORT INFORMATION <br />a <br />CONTRACTOR ■ <br />39000 <br />SUBSTANCE #1 �� <br />EMERGENCY RESPONSE <br />2�(p(p�q <br />1 2 3 4 5 6 7 $•:22, <br />RP SEARCH <br />S I N R <br />DATE UNDERWAY3•/��(TI <br />SITE CME <br />�� U <br />SOURCE OF FUNDS <br />S / <br />FED[[ EXEMPTI <br />i <br />Y / O <br />PETROLEUM <br />Y / N <br />SITE NAME `Tdn UIQ p5 U l Ab* -Y kD--- ` <br />ADDRESSvf <br />X461 S, Av- <br />CITY <br />a �S� �}�� ICA__ ZIP <br />SITE STATUS <br />DATE REPORTED v q- I <br />DATE CONFIRMED !! 1 <br />�a 6� MULTIPLE RP's Y <br />CASE TYPE <br />CONTRACT STATUS <br />I <br />STATUS CHANGE DATE <br />EMERGENCY RESPONSE <br />U (5) G D <br />1 2 3 4 5 6 7 $•:22, <br />RP SEARCH <br />S I N R <br />DATE UNDERWAY3•/��(TI <br />f <br />1 "7 <br />COMPLETED <br />3 • ZZ •�� <br />PRELIMINARY ASSESSMENT <br />U C <br />DATE UNDERWAY <br />it <br />�•2 2 -t-r <br />COMPLETED <br />REMEDIAL INVESTIGATION <br />U C <br />DATE UNDERWAY <br />COMPLETED <br />REMEDIAL ACTION <br />U I C, <br />DATE UNDERWAY <br />i <br />4 <br />COMPLETED <br />POST REM'ACT MONITORING <br />Y N U C <br />DATE UNDERWAY <br />COMPLETED <br />ENFORCEMENT ACT TAKEN <br />Y N <br />ENFORCEMENT TYPE 2 13 <br />4 5 6 <br />DATE'ACTIOl1'TAKEN" <br />LUFT CONSIDERATION1 <br />3 H S C A R <br />W G 0_. <br />EXCAVATION STARTED <br />CASE CLOSEDY <br />R C I <br />L <br />DATE CLOSED <br />REMEDIAL ACTION TAKEN <br />M C8 ED ET FP GT IT RS HU NA VS VE NT OT K <br />k <br />I <br />'Primary / Additional RESPONS BLE PARTY On <br />i <br />COMPANY NAME <br />PHONE <br />CONTACT NAME <br />'�� vv\ 5t,D <br />PHONE. <br />2� L <br />ADDRESS <br />CITY <br />��'�" ! <br />I <br />STATE <br />if <br />� <br />ZIP <br />II <br />4 <br />Additional RP's listed on REVERSE SIDE CONTAMINATED MFR'INFO on REVERSE SIDE <br />EN 23 083(09/89)REVISED 8/92 j 89-20(IV)01/90 PILMFA <br />