Laserfiche WebLink
�I PHSA..)JOADUIN COUNTY - ENVIRONMENTAL HEALTH DIVI <br /> ,�wn 310P PROGRAM - MFR INPUT FORM <br /> UPDATE _��- `�1 BY REVIEWED BY DATE ENTERED 11 ( BY <br /> ADDITION:_ EDIT:, <br /> pp,, # T- PRIORITY <br /> ENTERED.PILOT SWEEPS�'���v SJ/PHS CONTACT, � Gl - I <br /> i' NOR SENT - - LOC CODE C. DIST Z Z. PROGRAM/ELEMENT CODE Z9Z8 0 <br /> 1 <br />+I ,r SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 - Z07)`Z-- 5 <br /> i SITE CCOE 1 'k� SOURCE OF FUNDS S / (T FED EXEMPT Y / N. PETROLEUM / // N <br /> I <br /> SITE NAME �� � DATE REPORTED <br /> � <br /> 1 ADDRESS r�'1O E _ v DATE CONFIRMED - 301/0 <br /> 1! CITY ;. CAC 21P G� 5 Z-0C- MULTIPLE RP's Y / Q <br /> v - SITE STATUS <br /> CASE TYPE : CONTRACT STATUS STATUS CHANGE DATE., EMERGENCY RESPONSE <br /> U OG �.D� 1 2 3 4 5 8 9 <br /> I RP SEARCH / S I I N R' DATE UNDERWAY "1_ 5 v COMPLETED 2, 1 Ct Q <br /> PRELIMINARY ASSESSMENT U DATE UNDERWAY T _' " 9 COMPLETED <br /> - REMEDIAL INVESTIGATION U i DATE UNDERWAY ( r C) COMPLETED <br /> REMEDIAL ACTION U 1 © DATE UNDERWAY —� COMPLETED 7 <br /> I POST REM ACT MONITORING Y N U DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACT TAKEN Y �VENFORCEMENT TYPE 1 2 3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 ! 21l 3 CH'' R W G 0 <br /> j.. EXCAVATION STARTED ^ 1 j) CASE CLOSED / Y` ) R. H DATE CLOSED £ "? 31 <br /> REMEDIAL ACTION TAKEN l CD v CB F. ED ET`-� FP GT IT RS - HU NA VS! <br /> _Pr iawry / _Additional RESPONSIBLE PARTY <br /> COMPANY NAME e. i .a C PHONE 6 76 —/-1 I. <br /> C CONTACT NAME ..,,d, l -e/ PHONE _ "-71 �_ �/ <br /> ADDRESS © lam,,) t 'lJ��' G'l - Q <br /> vc <br /> STATE Cj 21P S z� <br /> CITY <br /> Additional RP's listed on REVERSE SIDE - CONTAMINATED MFR INFO on REVERSE SIDE <br /> 89-20(IV)01/90 PILMFA <br /> EH 23 083(09/89)REViSED 11/90 <br />