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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 Case ID: RO Existing FA <br /> CSU 0207/ 000 W?7 lFacilityID: <br /> SITE INFORMATION <br /> Business Name: S J Phone: <br /> Street#: sdx) Dir: w Street Name: ��ps Yf4 Type: &),j, <br /> City: �QEIl t ff bfolP State: C (� Zip: CJ S 3 <br /> County: 39-San Joaquin County APN: v'U <br /> CASE INFORMATION <br /> Program Element: q S Lj Assigned Name: MAINSITE yalgK[�� <br /> Regulatory Oversight Program: O Twi <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: A114 <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 0 Well Impact Description: None o R 4NKwd4>/� <br /> CASE MANAGEMENT <br /> Brownfield: I ®N—Site is not part of Brownfield Site Management Requirements: NA--No Action <br /> Current Land Use: ❑ Agricultural U5 Commercial ❑Industrial ❑Public Use ❑Residential <br /> [9 Exclude from Export **Leave blank unless PE code is any 2900 sites.** <br /> Completed By: f-J ufK14 v'-j Date: <br /> Entered By: Date: <br /> EH-29- <br /> 09/18/2007 <br />