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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.sigov.org/chd <br /> SITE REMEDIATION INFORMATION <br /> Site ID: SD gob Case ID: ROExisting FA zZZt/ Z <br /> Facilit ID: Dd ✓ <br /> SITE INFORMATION <br /> Business Name: e1 l G cf ?,v c, Phone: <br /> Street#: Dir: Street Name: (/>�l7X f#-� - Type: w <br /> City: (�)y, State: C s+ Zip: 95Z yb <br /> County: 39—San Joaquin County APN: 6Yq 12 <br /> CASE INFORMATION <br /> Program Element: 10 <br /> D Assigned Name: N >< ��C � <br /> Regulatory Oversight Program: 07-# L <br /> Funding for Regulatory Oversight: <br /> Funding for Cleanup: <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> Case Type: El -Drinking Water Supply Aquifer Affected El -Surface Water El -Soil Only <br /> ❑ W-Drinking Water Well Affected ® U-Undetermined Affected <br /> Beneficial Use: MUN—Municipal and Domestic Supply <br /> Vulnerability Basis: N/4- <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: !i 71Well Impact Description: None UnKP1 Gw <br /> CASE MANAGEMENT <br /> Brownfield: ®N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: I ❑ Agricultural gJ Commercial ❑ Industrial ❑ Public Use ❑Residential <br /> �(] Exclude from Export **Leave blank unless PE code is any 2900 sites.** <br /> Completed By: � Date: J? / <br /> Entered By: C Date: 7J jq <br /> EH-29- <br /> 09/18/2007 <br />