Laserfiche WebLink
PHSJOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVI <br /> LOP PROGRAM,- MFIt_INPUT FORM <br /> UPDATE 10_27p-I� BY' REVIEWED BY DATE ENTERED / BY <br /> x <br /> ;i ADDITION: iEDIT. ' <br /> ENTERED PILOT ���Z f�Q/. SJ/PHS CONTACT 1 L1�tJ2�l+ SWEEPS # /'y Z PRIORITY a / <br /> NOR SENT LOC CODE. 6f DIST, 3 23 PROGRAM/ELEMENT CODE <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 8t7�� () #3 05 <br /> SITE CODE �Cl'(pZ SOURCE OF FUNDS 5 i / pF FED EXEMPT_ -Y / PETROLEUM / N <br /> SITE NAME �3 DATE REPORTED t F <br /> EKb!ory �f�-5 <br /> ADDRESSApcf) JC S Z&La-,/-6 DATE CONFIRMED <br /> CITY CA ZIP gjZ-fJ y MULTIPLE-RP's Y /,- <br /> LC ; <br /> SITE STATUS <br /> t <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U g O D, 1 2 3 4 l©3 7 8 9 a �"r <br /> RP SEARCH (S' I N _ W I <br /> R DATE UNDERWAY CCMPLETfD <br /> 3. S ��1 <br /> PRELIMINARY ASSESSMENT U C DATE;UNDERWAY COMPLETED" -- <br /> OZ '22 _� tC7 - 7-- ct <br /> 1 <br /> REMEDIAL INVESTIGATION 1�UU �G DATE UNDERWAY i O 7�Q / COMPLETED <br /> REMEDIAL ACTION q U I C DATE UNDERWAY COMPLETED . H <br /> POST REM ACT MONITORING Y N':, U C DATE UNDERWAY COMPLETED <br /> i <br /> ENFORCEMENT ACT TAKEN Y N ENFORCEMENT TYPE 1 2 3 4 V 5 6^ DATE ACTION TAKEN <br /> LUFT CONSIDERATION .I 1 z 3� . O . "CSU U� QRS r C 0 y <br /> EXCAVATION STARTED I CASE CLOSED "Y R-. H A DATE CLOSED <br /> I <br /> r <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT IT RS HU NA VS' <br /> Additional RESPONSIBLE PARTY <br /> 1/ � e <br /> COMPANY NAME PHONE V��' <. � _ <br /> CONTACT NAME `��/- u. PHONE <br /> ADDRESS <br /> CITY yl STATE: ZIP <br /> Additional RP's O sted on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE + <br /> EH 23 083(09/89)REVISED 11/90 89720(IV)01/90 PILMFA <br />