Laserfiche WebLink
PHS , JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVh.,A <br /> Side B - LOP PROGRAM - MFR INPUT FORM <br /> UPDATE BY SITE CODE ADDRESS <br /> -AddTli�I RESPONSIBLE PARTY M A k 2tl �q <br /> ANNIPM NAME C�.li�e `LJ c�iY1.Gu.�z E <br /> CONTACT NAME �. PHONE <br /> ADDRESS L f Q 6 /f. -,t-FL— 3,S <br /> CITY STATE C� ZIP <br /> Primary / Additional RESPONSIBLE PARTY <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> Primary / Additional RESPONSIBLE PARTY <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONTAMINATED SITE MFR - Addition: Edit: <br /> UGT FILE FAILED PT SOIL CONT / / GW CONT / / DW CONT Y / N I I T <br /> PROPERTY OWNER <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANT PHONE <br /> RWOCB CONTACT UAR # DATE:_ _/ <br /> PROP 65 # DATE:_/ / <br /> DHS CONTACT <br /> WDR issued: Y / N NPDES issued: Y / N <br /> --jSTREET # SITE STREET APN # <br /> PILMFB revised 5/91 <br />