Laserfiche WebLink
P, AN JOAQUIN CCUNTY - ENVIRONMENTAL HEALTH DI ON <br /> LOP PROGRAM - MFR INPUT FORM <br /> UPDATE A) ,� � � BY REVIEWED BY �� q��' DATE ENTERED A ) q ! BY ' <br /> ®®® / / / <br /> ADDITION : `� EDIT : � <br /> ENTERED PILOT �p� . �/ SJ/PHS CONTACT �N `(� �/(� SWEEPS # PRIORITY O f <br /> NOR SENT / ') C `d LOC CODE 99 DIST 3 �. PROGRAM/ELEMENT CODE 24?, 26 <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 t,) ,5t,) ,5J / 2 7IY32 X0066 /9 5 <br /> SITE CODE ��� � SOURCE OF FUNDS S / © FED EXEMPT Y / V PETROLELM / N <br /> SITE NAME. / , DATE REPORTED <br /> IA16 254,4 /� At.56� r <br /> ADDRESS /�/ 153 GP/ �( 6h�'T G� "OCLUf DATE CONFIRMED <br /> CITY � _K f-O tiJ CA ZIP Q jZO y MULTIPLE RP' s Y / Q <br /> SITE STATUS <br /> CASE TYPE CONTRACT /STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U S © D 1 2 3 4 Q 7 8 9 / <br /> RP SEARCH OS I N R DATE UNDERWAY �. ', / Cl I COMPLETED Z GJ <br /> PRELIMINARY ASSESSMENT U © DATE UNDERWAY �. /�lll. o � COMPLETED [ <br /> REMEDIAL INVESTIGATION O 91,G DATE UNDERWAY / p .� �/ COMPLETED <br /> =REMEDIALON U I C DATE UNDERWAY COMPLETED <br /> IPOREM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> i <br /> ENFORCEMENT ACT TAKEN Y N ENFORCEMENT TYPE 1 2 3 /� 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 2 Uy O R ow &G 0 <br /> EXCAVATION STARTED CASE CLOSED Y R H DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT 1T RS HU NA VS <br /> _Primary / _Additional RESPONSIBLE PARTY <br /> COMPANY NAME \ / n1/b2/rY PHONE <br /> CONTACT NAME y✓o /J >tiE / ,/ A,OEE PHONE <br /> ADDRESSJlfJr�'� ` 7_ C J <br /> CITY STATE ZIP <br /> Additional RP � s listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE / <br /> EH 23 083 ( 09/89) REVISEO 11 /90 89- 20( IV) 01 /90 PILMFA <br />