Laserfiche WebLink
PHS/SAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION <br /> PILOT PROGRAM - MFR INPUT FORM <br /> i <br /> UPDATE ( �7 / BY IJ - REVIEWED BY � DATE ENTERED G Z� Gf,{ BY <br /> { G <br /> - y <br /> ADDITION: EDIT: <br /> ENTERED PILOT UO d SJ-PHS CONTACT SWEEPS 010,60 PRIORITY <br /> COMP # bEoLOC CODE ©1 D15T Z �� FPROG/ELEMENT CODE Z3 <br /> F SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SOURCE OF FUNDS 5y� / F SUBSTANCE /�rl1 !_ [ <br /> SITE CODE ,o � FED EXEMPT Y l�/✓Jvv N V� c PETROLEUM Y / N <br /> SITE NAMEb rI DATE REPORTED !� <br /> ADDRESS / /fl� DATE CONFIRMED <br /> CITY �[ �.0 5>f CA ZIP CATEGORY / S <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS EMERGENCY RESPONSE <br /> U S OG D 1 2 3 4 5 7 8 9 <br /> RP SEARCH I N R DATE UNDERWAY �� }� ? COMPLETED <br /> PRELIMINARY ASSESSMENT U'' C DATE UNDERWAY U (�+g COMPLETED <br /> REMEDIAL INVESTIGATION U C DATE UNDERWAY COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACT TAKEN Y N I ENFORCEMENT TYPE 1 2 3 4 5 G DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 2 3 S C A G 0 <br /> EXCAVATION STARTED Zg CASE CLOSED Y R H DATE CLOSED <br /> REMEDIAL ACTION TAKEN D CS ED ET FP GT IT RS HU NA VS <br /> RESPONSIBLE PARTY <br /> COMPANY NAME GCe.cr1- PHONE <br /> w, d a L,-7s- 0 <br /> CONTACT NAME N D'„- �Q PHONE '� "7 <br /> ADDRESS <br /> CITY STATE ZIP <br /> EH 23-083(09/89)REVISED 01/90 <br /> 89-20(IV)01/90 PILMFR <br />