Laserfiche WebLink
PHS/SAN JOAQUIN COUNTY — ENVIRONMENTAL HEALTH DIVISION <br /> CONTAMINATED SITE MFR — INPUT FORM <br /> UPDATE /G / C) BY � REV IEWED BY Yt�� DA-rE ENTERED /�� /�v BY <br /> ADDITION• './ EDIT: <br /> SWEEPS # 7 c f� COMPUTER # D IST # LOC CODE <br /> UGT FILE H W FILE �X' LAND USE FILE PWS FILE PILOT FROG <br /> FAILED PT / / SOIL CONT ,, / -1 /�r GW CONT / "771,( e DW CONT <br /> PETROLEUM / N ENTERED PILOT / / FROG/ELEMENT <br /> SITE NAME Z% � 5/'e- <br /> ADDRESS - v, C�! �� //. PHONE <br /> CITY ` STATE CA ZIP �< -57 <br /> CONTACT NAME CROSS STREET o7vs <br /> PROPERTY OWNER <br /> NAME /r �j/ <br /> MAILING/STREET ADDRESS <br /> 0253 ?w 7x, <br /> CITY �i�?� /S STATE ZIP <br /> CONTACT NAME � e �� PHONE <br /> RESPONSIBLE PARTY ( If different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE Z IF' <br /> CONSULTANT r _ PHONE (/4SJ/EH CONTACT1647111 <br /> RWQCB CONTACT <br /> DHS CONTACT <br /> OTHER CONTACT <br /> UAR # — DATE / / PROP 65 # DATE <br /> STREET # SITE STREET PRIORITY <br /> EH 23 070 (7/89) 89-19 ( IV)7/89 CNTMFR <br />