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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 /> Site ID: SD 000 ki 0 W Case ID: RO 000;Z�3� Existing FA <br /> Facilit 1D• <br /> SITE INFORMATION <br /> Business Name: )3,f/U67a Ac-e-7-21 Phone: <br /> Street#: Dir: S Street Name: �tType: <br /> City: (ZENr?N C oqn'1 P State: Zip: QSZ 3 1 <br /> County: 39—San Joaquin County APN: f _ 3 ,-2 <br /> CASE INFORMATION <br /> Program Element: �_4` r0 [Assigned Name: MAINSITEv�4KU� <br /> Regulatory Oversight Program: <br /> Funding for Regulatory Oversight: P <br /> Funding for Cleanup: R P <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> ❑ A-Drinking Water Supply Aquifer Affected El -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: <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 0 Well Impact Description: None O Q 4 jVKA10W tU <br /> CASE MANAGEMENT <br /> Brownfield: ®N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: ❑ Agricultural 1�71 Commercial ❑ Industrial ❑ Public Use ❑Residential <br /> Exclude from Export **Leave blank unless PE code is any 2900 sites.** <br /> -PL <br /> Completed By: Date: to-to . IV <br /> Entered By: lJmN1 Date: 10/I0f(w <br /> EH-29- <br /> 09/18/2007 <br />