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0 • <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: w Av.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> Site ID: SD Case ID: RObOO�(f[`6 Existing FAb p n,�a�/ <br /> 9 FacilityID: <br /> SITE INFORMATION <br /> Business Name: I j-b 46qD hone: <br /> Street Dir: 5 Street Nari � G,eo { Type: L.fif&E <br /> City: /—d0 / State: Zip: QS Zq 0 <br /> County: 39—San Joaquin County APN: �j Y C.7 d <br /> CASE INFORMATION <br /> Program Element: m U „ `'�-?Cj Assigned Name: MAINSITE - YEWt lst7 <br /> Regulatory Oversight Program: QT(f <br /> Funding for Regulatory Oversight: <br /> Funding for Cleanup: P <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> Case Type: ❑ A-Drinking Water Supply Aquifer Affected El F-Surface Water ❑ S-Soil Only <br /> ❑ W-Drhdcing Water Well Affected [ U- Undetennined Affected <br /> Beneficial Use: MUN—Municipal and Domestic Supply <br /> Vulnerability Basis: 1 cU wr+ <br /> MTBE Threat Classification: I �X MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 0 Well Impact Description: None (Z U <br /> Ol/tl <br /> CASE MANAGEMENT <br /> Brownfield: ® N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: ❑ Agricultural ❑ Commercial X Industrial ❑ Public Use ❑ Residential <br /> XN Exclude from Export :-Leave blank unless PE code is any 2900 sites.' <br /> Completed By: Date: <br /> ` Date: <br /> Entered By: -------- -(/ if _ Date: ----- <br /> EH_29_ <br /> 09/18/2007 <br />