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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: vwvw.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> ID: SD v 7� Case ID: RO Existing <br /> Site <br /> Cx,� � �C z ll5 Facility ID: I <br /> FA <br /> SITE INFORMATION <br /> Business Name: 10 � Gv 1 k D 4(— Phone: <br /> Street#: Dir: Street Name: ���., 2 Type: J)k I U� <br /> City: 5 C rok, State: Zip: 9`7 2 O <br /> County: 39—San Joaquin County APN: (0 2—a 3U— U/ <br /> CASE INFORMATION <br /> Program Element: -�'9�0 Assigned Name: MAINSITE <br /> Regulatory Oversight Program: C> 7--61 It- <br /> Funding <br /> Funding for Regulatory Oversight: /, <br /> Funding for Cleanup: <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: P14 <br /> MTBE Threat Classification: V MTBE Cleanup Classification: I NA <br /> Number of Impacted WellT- O Well Impact Description: None d le <br /> CASE MANAGEMENT <br /> Brownfield: ®N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: I ❑ Agricultural ❑ Commercial '0Industrial ❑Public Use ❑Residential <br /> R Exclude from Export **Leave blank unless PE code is any 2900 sites.** <br /> Completed By: Date: 5' • 'L - `� <br /> Entered By: J y Date: <br /> EH-29- <br /> 09/18/2007 <br />