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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 /> FSS e ID: SDD�?.c7 Case ID: <br /> �ROO Z(( ( Existing <br /> Facilit ID: <br /> SITE INFORMATION <br /> Business Name: 5 T►9r( CX 7-E4.,5fot) Phone: <br /> Street#: Dir: Street Name: S j/}r� RTC Type: <br /> City: 517 e h-DA) State: C Zip: Z 0 3 <br /> County: 39—San Joaquin County APN: Qv (,J <br /> CASE INFORMATION <br /> Program Element: C/5-a Assigned�Name-�MAI�NSITE��. <br /> Regulatory Oversight Program: <br /> Funding for Regulatory Oversight: <br /> Funding for Cleanup: tP <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: N A <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 0 Well Impact Description: None © k, u KA-10W <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 /> .. Exclude from Export "Leave blank unless PE code is any 2900 sites.*" <br /> Completed By: ��•�; - Date: <br /> Entered By: Date: L <br /> EH-29- <br /> 09/18/2007 <br />