Laserfiche WebLink
PMS/SAN )L;KCUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION...i <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM <br /> UPDATE: / /� l�BY: REVIEWED ST: DATE ENTERED: <br /> SWE°PS/SITE CODE PROGRAM/ELEMENT Z.3 �j() COMP x I//,N�.� LOC CODE U 1 DIST Y '3 Z' <br /> UGT FILE PILOT FILE H W FILE SITE MITIGATION PVS FILE PRIV WELL FILE_ ENV ASSESS <br /> SOLID WASTE S20 0 FILE EPI FILE LAND USE FILE OTNER AGENCY REPORT 'c)IERGENCY RESPONSE <br /> LEAD AGNCY/UNIT SJ/EH CONTACT DHS CONTACT -- <br /> OTHER CONTACT RWOC3 CONTACT WOR issued Y / N NPOES issued /Y I N <br /> FAILED PT SOIL CONT &7-/ l -"I v GW CONT OU CONI ETROIEUM /Y J/ N <br /> SUBSTANCE ,Yt 12-03-2-- 2 «� EUPCWLETE <br /> ✓ 13 <br /> PRICR FAILED PT NO ACTION CLEAN I DATE ENFORCEMENT ACTION Y / N <br /> ENFORCEMENT TYPE: 1 2 3 4 S 6 DATE ACTION TAKER: <br /> SITE SAME <br /> ADDRESS <br /> CITY STATE ZIP qsz-.03 <br /> CCN TACT NAME I PHONE <br /> PRCPEATT OWNER I �7Ayyy/// <br /> CCMPANY NAME ...I n V L PHONE . //-{'�� g�� <br /> CONTACT NAME L 2 PSE , v <br /> ADDRESS J✓� �( h/ L)1Ce� ���Iyy, <br /> CITY STATE /„Q ZIP <br /> Oxy <br /> RESPSZ8LE PARTY (If different from Property Owner) ll// �� / <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANTCJhEldPHONE / <br /> � 2, - <br /> IV <br /> —71 UM t DATE C9 -1 -Lj -y PPIRCP 65 X OAiE � 1 y�Z PRIORITY <br /> STREET Y 2 SITE STREET <br /> STREET I / ±C1.O�rn�r��� APR d <br /> -± -' `Z^. f7/AO imn±t epi ^,T:Ot A0.'O/tVl GV TMFR2 <br />