Laserfiche WebLink
PH::: 4 JOAGUIN COUNTY - ENVIRONMENTAL HEALTH DIV. 1 <br /> CONTAMINATED SITE 0-Base MFR - INPUT FORM `. <br /> UPDATE: / / BY: REVIEWED BY: DATE ENTERED: BY: <br /> SWEEPS/SITE CODE �� PROGRAM/ELEMENT 3CCMP 9 c LOC CODE O/ DIST 9 3�3 <br /> UGT FILE PILOT FILE H 4 FILE SITE MITIGATION PWS FILE PRIV HELL FILE ENV ASSESS <br /> SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> LEAD AGNCT/UNIT TTT' SJ/EH CONTACT t DHS CONTACT - - <br /> OTHER CONTACT R%ACB CONTACT WOR issued Y / Cl—�; NPOES issued Y / (Rt <br /> FAILED PT / 2_- SOIL CONT GW CONT OW CONT ETROLEUM Y / N <br /> SUBSTANCE #1 / `. 3 y #2 #3 ;9 #5 <br /> PRICR FAILED PT NO ACTION CLEAN UP COMPLETE GATE ENFORCEMENT ACTION Y / N <br /> ENFORCEMENT TYPE: 1 2 3 G S 6 DATE ACTION TAKEN: <br /> SITE NAME <br /> ,LDORESS rl <br /> CITY c /� ,.� STATE (`/� 2(P <br /> CONTACT NAME I /l'F Y C PHONE �y _ �/6. s- - 3 35 7 <br /> PRCPEATY OWNER <br /> CCMPANY NAME -� PHONE c _X10 - 3 3 5 7 JG c � ci..v �G�L[ n�c CEJ <br /> CONTACT NAME PHONE <br /> l� <br /> ADORERS 2— <br /> CITY -1 ) <br /> CITYG) STATE ?1 Z[P <br /> L A <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAMEr PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANT PHONE <br /> UAR # � _ DATE PROP 65 s � _ �a.�- _ DATE Z, PRIORImt <br /> STREET 9 ��- SITE STREET ��� ;> Gk APN ft <br /> EH 23 070 (7/89)REVISeD 03/91 89-19(IV) C.NTMFR2 — - - <br />