Laserfiche WebLink
PHSA! OAQJIN COUNTY - ENVIRONMENTAL HEALTH DIV15Nsof <br /> LOP PROGRAM - MFR INPUT FORM <br /> [UPDATE 3 BY REVIEWED BY J� DATE ENTEREDI�� <br /> � BY <br /> ADDITION• ! EDIT: <br /> ENTERED PILOT y-LQ .93 SJ/PHS CONTACTSWEEPS PRIORITY <br /> NOR SENT . Z� 3 LOC CODE Q1 DIST 32 3 PROGRAM/ELEMENT CODE 3C 2, 7 <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR 0 39000SUBSTANCE #1 12 a? <br /> SITE CODE 2 590 SOURCE OF FUNDS S / U FED EXEMPT Y / PETROLEUM L 'J / N <br /> SITE NAME !/ DATE REPORTED 2 Z <br /> ADDRESS lQ� C�[ DATE CONFIRMED <br /> C—ITY1MULTIPLECA ZIP q5 RP's Y / <br /> SITE STATUS 6 O <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U 0 G D 1 2 0 4 5 7 8 9 �j�-2,0,!?3 I <br /> RP SEARCH O5 I N R DATE UNDERWAY 41 0 3 ( COMPLETED <br /> SZ(�3 <br /> PRELIMINARY ASSESSMENT U V DATE UNDERWAY 30 C04PLETED <br /> REMEDIAL INVESTIGATION DATE UNDERWAY - ?, COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT 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 6—o CASE CLOSED Y R H DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD CS ED ET FP GT IT RS HU NA VS <br /> ✓Primary / Additional RESPONSIBLE PARTY <br /> COMPANY NAME PHONE <br /> CONTACT NAME I /Lf' Sh PHONE <br /> ADDRESS Or 7 ! / <br /> CITY �/ � _ STATE ZIP <br /> Additional RP's Listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> EH 23 083(09/89)REVISED 11/90 89-20(IV)01/90 PILMFA <br />