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PHS/&,./JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVI....... <br /> IAP MFR SIDE A - ADDITION:_ EDIT: <br /> /} <br /> UPDATE 2 95 HY ` y) REVIEWEDy�BY DATE ENTERED HY <br /> ENTERED LOP l SS/PHS CONTACT p/ q�i�.Q _ DISK# C A—Q PRIORITY <br /> NOR SENT IAC CODE I I SUPR DIST u' PROD/ELEM 530 WDR Y / N NPDES Y / N <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR #139000 SUBSTANCE #1 2 3 4 5 <br /> SITE CODE I I 5 q 1 OURCE OF FUNDS S / F FED EXEMPT Y / N PETROLEUM Y / N <br /> SITE NAME t�r q� DATE REPORTED <br /> ADDRESSc , (0—o1 1��^�`.v/�1 / DATE CONFIRMED <br /> CITY _ iT✓` IYJ�R— CA I ZIP q5„(//4 MULTIPLE RP's Y / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U S G D 1 2 3 4 5 6 7 8 <br /> RP SEARCH S I N R DATE UNDERWAY COMPLETED <br /> PRELIMINARY ASSESSMENT :I c DATE UNDERWAY COMPLETED <br /> REMEDIAL INVESTIGATION :1 c DATE UNDERWAY COMPLETED <br /> REMEDLAL ACTION U I _ DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACL TAKEN Y N ENFORCEMENT TYPE 1 2 3 4 S 6 DATE ACTION TAKEN <br /> LUST CONSIDERATION 1 2 3 H S C A R W G 0 / I <br /> EXCAVATION STARTED / / CASE CLOSED Y R C L DATE CLOSED <br /> REMEDIAL ACTION TAKEN CB ED ET FP GT IT HE HU NA VS VE NT OT UK <br /> SITE AND FILE STATUS <br /> DEPTH TO WATER G GRADIENT WELLS NEARBY >S00 Loo 00 FT >2000 PT TYPE IR DOM PUB <br /> LAST SAMPLING DATE FLAG DATE OAR # PROP65 # <br /> CONTAMINATED SITE MPR - Addition:_ Edit:_ DATE <br /> UGT FILE FAILED PT / / SOIL CONT GW CONT / / DW CONT Y / N <br /> CONSULT CONTACT ENOCH CONTACT TSC CONTACT <br /> STREET # SITE STREET TA <br /> # <br /> PROPERTY OWNER(S) AND ADDITIONAL RP'S ED ON SIDE B Y / N <br />