Laserfiche WebLink
PHS/SA GUIN COUNTY - ENVIRONMENTAL HEALTH DIVISV <br /> CMYAMINATED SITE D-Base MFR - INPUT FORM �. <br /> UPDATE: BY: � REVIEWED BY: DATE ENTERED: /y -74 GI BY: . <br /> SWEEPS/SITE CODE !! PROGRAM/ELEMENT 23,E COMP # /4R(o5 ?-,-7 LOC CODE � DIST; 3� <br /> UGT FILEIx I PILOT FILE X I H W FILEF SITE MITIGATION PWS FILE PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O O FILE 1 EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> LEAD AGNCY/UNIT /i/1� S!/EN CONTACTrG� PWI DHS CONTACT <br /> OTHER CONTACT I/ Y RWOCS CONTACT WDR issued Y / N NPDES issued Y / N <br /> FAILED PT SOIL CONT GW CONT DW CONT ETROLEUM / N <br /> SUBSTANCE #1 #2 /�-G 1 #3 94 #5 <br /> PRIOR FAILED PT NO ACTION CLEAN UP COMPLETE DATE ENFORCEMENT ACTION Y / N <br /> ENFORCEMENT TYPE: 1 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME <br /> ADDRESS <br /> CITY STATE G ZIP <br /> CONTACT NAME I / i//'-/ 11� PHONE �)369 -736 <br /> PROPERTY OWNER / ,,V /'T' (/ !� <br /> COMPANY NAME /y/1/D RDD�G �D PHONE <br /> CONTACT NAME /r,¢- PHONE l'7 777 <br /> ADDRESS <br /> CITY �— <br /> RESPONSIBLE PARTY (If different from Property Owner) / <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE - <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANT PHONE <br /> UAR # DATE PROP 65 # DATE 6 /p RRITY <br /> STREET # `J SITE STREET / GO�i/E/ II APN #P <br /> EH 23 070 (7/89)REVISED 03/91 89-19(IV) CNTMFR2 <br />