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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: SDCase ID: RO (XVI 15q Existing FA <br /> d�211� I Facility ID: <br /> SITE INFORMATION C <br /> Business Name: +56 a Of}S/ -5 Phone: <br /> Street#: xp Dir: 5 Street Name: 6L- po knk3 Type: S+r <br /> City: 5jA4 State: &y- Zip: Q5-206 <br /> County: 39-San Joaquin County APN: 142- 6 3'3,2 <br /> CASE INFORMATION <br /> Program Element: ;�Cj 5_0 Assigned Name: MAINSITE -yGWeL,,wj <br /> Regulatory Oversight Program: (DT L <br /> Funding for Regulatory Oversight: j <br /> Funding for Cleanup: P <br /> File Location: L-Local Agency <br /> RISK MANAGEMENT <br /> ❑A-Drinking Water Supply Aquifer Affected ❑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: A) <br /> MTBE Threat Classification: X MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 1 0 Well Impact Description: I None O e u ti KddlvU <br /> CASE MANAGEMENT <br /> Brownfield: ®N-Site is not part of Brownfield Site Management Requirements: NA-No Action <br /> Current Land Use: ❑ Agricultural ❑ Commercial ❑ Industrial ❑Public Use (`Residential <br /> xclude from Export **Leave blank unless PE code is any 2900 sites.** <br /> Completed By: Date: <br /> Entered By: Date: <br /> EH-29- <br /> 09/18/2007 <br />