Laserfiche WebLink
-- I <br /> I <br /> PHS JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVIS <br /> LOP PROGRAM - FR INPUT FORM <br /> I <br /> UPDATE REVIEWED BY <br /> DATE ENTERED �� �-- � <br /> BY <br /> ADDITION• EDIT: y <br /> ENTERED PILOT SJ/PHS CONTACT SWEiEPS # <br /> PRIORITY <br /> 1 it <br /> NOR SENT LOC'CODE DIST ' <br /> PROGRAM/ELEMENT CODE _�J /J& <br /> D�-{(/ <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 i <br /> i! <br /> SITE CODE SOURCE OF FUNDS S / F FED EXEMPTS Y II / N PETROLEUM Y / N <br /> V C.d lJ III <br /> (l il <br /> SITE NAME S4 J Octcj C)i �p 4 i! DATE REPORTED <br /> ADDRESS �` DATE CONFIRMED <br /> CITY T <br /> A ZIP 952�i2 MULTIPLE RP's Y / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS I�STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U 5,��_,0 1 2 3 - y O 7 8 4" �-. (� <br /> RP SEARCH S I N R DATE UNDERWAY COMPLETED <br /> PRELIMINARY ASSESSMENT U C DATE UNDERWAY i` COMPLETED <br /> REMEDIAL INVESTIGATION U DATE UNDERWAY I COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY �� I{ COMPLETED <br /> II <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY [ COMPLETED <br /> li <br /> ENFORCEMENT ACT TAKEN Y N ENFORCEMENT TYPE 1 2 3 11 5 6 DATE ACTION TAKEN <br /> 7 <br /> LUFT CONSIDERATION 1 2 3 H S C A R W G 0 <br /> II II <br /> EXCAVATION STARTED CASE CLOSED Y R 'H DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD co ED ET FP GT } IT"I RS HU NA VS <br /> Primary / Additional RESPONSI LE PARTT <br /> COMPANY NAME PHONE <br /> ,F a� <br /> CONTACT NAME PHONE <br /> Fi II <br /> ADDRESS <br /> I� <br /> i <br /> CITY STATE` ZIP <br /> ik <br /> Additional RA's listed on REVERSE SIDE CONTAMINAT,ED MFR)NFO on REVERSE SIDE <br /> EH 23 083(09/89)REVISED 11/90 j� 89-20(IV)01/90 PILMFA <br />