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% <br /> POWISAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION / <br /> LOP MFR SIDE A - ADDITION:_ EDIT:_ <br /> UPDATE BY <br /> REVIEWED BY GATE ENTERED <br /> / BY <br /> ENTERED LOP SS/PHS CONTACT % /: DISK# /I�-�'� PRIORITY <br /> NOR SENT LOC CODE wvg DIST _3 PROG/ELEM WDR Y / N NPDES Y / N <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION) <br /> CONTRACTOR # 39000 SUBSTANCE #1 ts <br /> OUACE OF FUNDS S / P PID h'%EP@T Y / N PETROLEUM Y / N <br /> SITE NAME i�✓� Y ti.l' .��r i _ -� DATE REPORTED <br /> ADDRESS "r,��. 2 l ww✓✓1lL%c. DATE CONFIRMED <br /> CITY CA ZIP 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 3 <br /> RP SEARCH S I N R DATE UNDERWAY COMPLETED <br /> PRELIMINARY ASSESSMENT U C DATE UNDERWAY COMPLETED <br /> REMEDLAL INVESTIGATION II C DATE UNDERWAY COMPLZ=D <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFO <br /> RCEMENT ACT TAKEN Y N ENFORCEMENT TYPE 1 2 3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 2 3 H S C A R W G 0 <br /> EXCAVATION STARTED CASE CLOSED Y R C T DATE CLOSED <br /> REMEDIAL ACTION TAKEN CB ID ET FP GT IT RS HU NA VS VE NT OT UK <br /> SITE AND FILE STATUS <br /> DEPTH TO WATER GRADIENT WELLS NEARBY >500 FT 11000 FT >2000 7!' TYPE IR DOM PUB <br /> LAST SAMPLING DATE FLAG DATE OAR # PROP65 # <br /> CONTAMINATED SITE MFR - Addition:_ Edit:_ DATE I <br /> UGT FILE FAILED PT / / SOIL CONT / / TW CONT / / DW CONT Y / N <br /> CONSULT CONTACT RWQCH CONTACT TSC CONTACT <br /> STREET # SITE STREET APN # <br /> PROPERTY OWNER(S) AND ADDITIONAL RP'S NOTED ON SIDE e Y / N <br />