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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Sheet, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: ww%v.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> Site lD: SD baQZ I 'aseID: R00oo � Existing FA OI � 29 <br /> 4� Facility [D r7 <br /> SITE INFORMATION <br /> oBusinessName: N( f„� ��•l.Qj� �� Phone:Dir: 5 Street Name: �R4A/ Type:,C SCA LOQ State: CI Zip:9-San Joaquin County APN: a� .Z <br /> CASE INFORMATION <br /> Program Element: ��( So Assigned Name: MAINSITE <br /> Regulatory Oversight Program: <br /> Funding for Regulatory Oversight: <br /> Funding for Cleanup: P <br /> File Location: L-Local Agency 1 <br /> RISK MANAGEMENT <br /> Case Type: ❑ A-Drinking Water Supply Aquifer Affected ElF-Surface Water ❑ S -Soil Only <br /> ❑ W- Drinking Water Well Affected U-Undetermined Affected <br /> Beneficial Use: MUN-Municipal and Domestic Supply <br /> Vulnerability Basis: N <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA NUKaowU <br /> Number of Impacted Wells: 0 Well Impact Description: None <br /> CASE MANAGEMENT <br /> Brownfield: ® N - Site is not part of Brownfield Site Management Requirements: NA -No Action <br /> Current Land Use: �� Agricultural ❑ Commercial ❑ Industrial ❑ Public Use ❑ Residential <br /> Exclude from Export "Leave blank unless PE code is any 2900 sites -- <br /> r <br /> mpleted By: ODate; t� -�,,/tered By: Date: <br /> EH-29- <br />