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PHS/SAN JOFMIN COUNTY — ENVIRONMENTAALTH DIVISION <br />CIMTAMINATED SITE MFR — INGUOFORM <br />UPDATE / / BY <br />,7g qL e REVIEWED BY DATE ENTERED rZ/r0 /�,/ BY <br />ADDITION• EDIT: U <br />SWEEPS # COMPUTER # <br />z�- S Fr,I DIST # .3z� LOC CODE <br />UGT FILE H W FILE LAND USE FILE <br />GWS FILE :•PILOT I�RCG <br />FAILED PT / / SOIL CONT <br />/ / GW CONT / / DW COIVT <br />PETROLEUM Y / N ENTERED PILOT <br />PRDG/ELEMENT <br />SITE NAME n <br />K S <br />ADDRESS <br />y`1 iJ� rt <br />CITY PHONE L <br />6 N STATE CA ZIP <br />CONTACT NAME <br />i 0 <br />PROPERTY OWNER MCROSS STREET n� <br />NAME <br />�� esPHONE <br />MAILING/STREET ADDRESS C <br />CITYS5— <br />c <br />STATE <br />CONTACT NAME ZIP <br />PHONE _ <br />RESPONSIBLE PARTY (If different from Property <br />P y Owner^) <br />COMPANY NAME <br />S <br />CONTACT NAME PHONE <br />_� <br />ike -ow1Pr PHONE <br />ADDRESS 2 8 Z <br />CITY <br />STATE ZIP <br />CONSULTANT <br />SJ/EH CONTACT PHONE <br />N <br />RWQCB CONTACT <br />DHS CONTACT <br />OTHER CONTACT <br />UAR # /0 DATE <br />PROP 60 # <br />STREET # 3 DATE <br />SITE STREET <br />EH 23 070 (7/89)PRIORITY <br />89-19(IV)7/89 CNTMFR S <br />