Laserfiche WebLink
PHS/SAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION <br /> J CONTAMINATED SITE MFR - INPUT FORM <br /> I ; <br /> UPDATE By e,dL REVIEWED BY DATE ENTERED <br /> �.: <br /> ADDITION• DIT <br /> SWEEPS # � COMPUTER # p,,z7crA3S DIST # 3a� LOC CODE <br /> UGT FILE H W FILE LAND USE FILE PWS FILE PILOT PRGG <br /> FAILED P7 / / SOIL CONT /,9a /8-9 GW CONT / / DW CONT <br /> PETROLEUM Y N ENTERED PILOT / / FROG/ELEMENT <br /> SITE NAME <br /> ADDRESS <br /> E / PHONE <br /> 3S3 S �`j erp /c�P <br /> CITY STATE C(1 ZIF yS�o <br /> CONTACT NAME rub GL7o0/Se 9y6 9Y/y CROSS STREET <br /> PROPERTY OWNER <br /> NAME Off/ %rc(cE S4 /eS �i,c -HONE <br /> MAILING/STREET ADDRESS 3lv SS v/ <br /> CITY STATE �� ZIF 95 SOS <br /> CONTACT NAMEQ sit PHONE <br /> /J/2lCP Ci.�oc�-5-e /(o F�-arrE W, circ/ 9 /rr- <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME PHONE <br /> I <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP' <br /> CONSULTANT _ Lug /1cr.d,so� PHONE <br /> �SfDc/.1�.� -SPrv,ce S��c< fs�a� <br /> SJ/EH CONTACT <br /> RWQCB CONTACT l �t <br /> DHS CONTACT <br /> OTHER CONTACT <br /> UAR # 10r, <br /> - I DATE I /a,� /f'� PROP 65 # �'CI- I S( DATE ! ( <br /> STREET # 35 � s SITE STREET . ��� ,lL ` UU PRIORITY <br /> EH 23 070 (7/89) 89-19 ( IV)7/89 CNTMFR <br />