Laserfiche WebLink
PHS* JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIV <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM n <br /> UPDATE: / //6 /y- BY: REVIEWED BY: DATE DATE ENTERED: 501 / L� / q-J BY <br /> SWEEPS/SITE CODE 6 PROGRAM/ELEM`EN/T 12� /Q COMP # IFE14 /A ) q LOC CODE � DIST # `3 Z3 <br /> LOT FILE PILOT FILE H W FILE X SITE MITIGATION PUS PILE lT 1 PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O O FILE EPI FILE/ ` LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> LEAD AGNCY/UNIT ( �� SJ/EH CONTACT " <br /> I 1 DHS CONTACT - - <br /> OTHER CONTACT RWOCB CONTACT WDR issued Y /(3N) NPDES issued Y /(:nN <br /> FAILED PT SOIL CONT �_ C� GW CONT �_�- / DW CONT ETROLEUM Y <br /> SUBSTANCE #1 #2 A/�0,3 #3 1 #4 #5 <br /> PRIOR FAILED PT NO ACTION CLEAN UP COMPLETE DATE ENFORCEMENT ACTION Y <br /> ENFORCEMENT TYPE: 1 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME <br /> ADDRESS �J©S <br /> CITY L � � •���ccc/// STATE �C ZIP <br /> CONTACT NAME �� � PHONE <br /> PROPERTY OWNER <br /> COMPANY NAME PHONE / y-J <br /> 2 _ 70 <br /> �` <br /> CONTACT NAME / PHONE (� J/a/ <br /> ADDRESS A2 4 <br /> CITY It,? G�Cf�t! STATE ZIP <br /> RESPONSIBLE PARTY (If different from Property Owner) / <br /> COMPANY NAME OPHONE <br /> CONTACT NAME // L✓ �T l PHONE <br /> ADDRESS ()060y �?0 C7 <br /> CITY � Z�� V STATE ZIP <br /> CONSULTANT / / f/ PHONE <br /> UAR # DATE t" PROP 65 # / /3 DATE 2 Gt PRIORITY <br /> STREET # /x0 <br /> O-5 SITE STREET rv::?AQ APN # /q(.l_/150_©y-3 <br /> EH 23 070 (7/89)REEVISED 03/91 89-19(IV) CNTMFR2 <br />