Laserfiche WebLink
PHS!!( JOAQUIN COUNTY - ENVIRONMENTAL HEALTH OIVIVC <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM I <br /> UPDATE: 2 / 'C� /C�I By: ��/ REVIEWED BY: p DDATE�ErNTERED::j/ / �j� / �( By: �/' <br /> SWEEPS/SITE CODE �5PROGRAM/ELEMENT <3 �6 COMP # ( OA/f)0 T6 LOC CODE 9H DIST 3Z-' <br /> UGT FILE PILOT FILE H W FILE SITE MITIGATION PWS FILE PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> LEAD AGNCY/UNIT `f{fi SJ/EH CONTACT DHS CONTACT - - <br /> OTHER CONTACT Jam-- RWOCS CONTACT WDR issued Y / N NPDES issued Y / N <br /> FAILED PT �Z/3�/g 8 SOIL CONT GW CONT OW CONT ETROLEUM / N <br /> SUBSTANCE #1 92 #3 #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 on/solidafed �re� hf� S <br /> ADDRESS <br /> CITY tY[ STATE C�� ZIP ��2 06 <br /> CONTACT NAME SO h n / ? / PHONE 209)982- y8i3 <br /> PROPERTY OWNER <br /> COMPANY NAME �n l �iy n- rO j � LJ. PHONE / q <br /> CONTACT NAME 7o h n Kn e riU��ill �� GJ[ PHONE /209 9yF 2 yF�3 <br /> ADDRESS /y1 5- L I nT lle[ `-d A l V6 l v <br /> CITY Men <br /> JD dr/< STATE C,q ZIP <?yOZ/`-0 <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY r STATE�1 qpZIP / \ <br /> CONSULTANT PHONE^���C]]]�`�) <br /> UAR # DATE I 8 9 PROP 65 # DATE /5 f�(� PRIORITY <br /> STREET 0 SITE STREET 1 ,41 �}-�.7f CCCA//PN # <br /> EH 23 070 (7/89)REVISED 03/91 89-19(IV) CNTMFR2 V, <br />