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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: www.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> Site ID: SD 00472_,d3`L Case ID: ROO-Olo-Z064 Existing FA <br /> Facility [D: <br /> SITE INFORMATION <br /> Business Name: e17-Y P Phone: <br /> Street#: X50/ Dir: Street Name: D `9R� Type: Pk/N <br /> City: Awrwu P State: 4 Zip: �'f33a <br /> County: 39—San Joaquin County APN: /1 U ' /3c)' 3 Z <br /> CASE INFORMATION <br /> Program Element: I Aq Q Assigned Name: MAINSITE yo�3Krt <br /> Regulatory Oversight Program: <br /> Funding for Regulatory Oversight: (, <br /> Funding for Cleanup: 1 8 P <br /> i <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> El -Drinking Water Supply Aquifer Affected El F-Surface Water ❑ S-Soil Only <br /> Case Type: <br /> ❑ W-Drinking Water Well Affected ❑ U-Undetermined Affected <br /> Beneficial Use: MUN—Municipal and Domestic Supply <br /> Vulnerability Basis: • /111 <br /> MTBE Threat Classification: v MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 1 0 Well [m pact Description: Nolte O2 UuKivotV0r1 <br /> CASE MANAGEMENT <br /> Brownfield: ® N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: ❑ Agricultural ,K Commercial ❑ [ndushial ❑ Public Use ❑ Residential <br /> Exclude from Export "Leave blank unless PE code is any 2900 sites." <br /> Completed By: tXXt.�U(� Date: <br /> Entered By: Date: <br /> EH-29- <br /> 09/18/2007 <br />