Laserfiche WebLink
PHS*JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVIO <br /> LOP PROGRAM - MFR INPUT FORM <br /> UPDATE8. 'z?�.G'L BYWWIREVIEWED BY =D� 11ATE ENTERED BY <br /> v ✓✓ II ADDITION:_ EDIT:_ <br /> ENTERED PILOT SJ/PHS CONTACT S SWEEPS # PRIORITY <br /> NOR SENT LOC CODE �J DIST PROGRAM/ELEMENT CODE <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 5 <br /> SITE CODE /] SOURCE OF FUNDS S / F FED EXEMPT Y / N PETROLEUM Y / N <br /> SITE NAME '� InO ls SocDATE REPORTED <br /> -2- H <br /> ADDRESS ` I CCC ic-Akkkk____.J r0Ur ZIP I /A DATE CONFIRMED <br /> CITY � .1 CA �/� MULTIPLE RP's Y / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U S G D 1 2 3 4 5 7 8 9 <br /> RP SEARCH S 1 N R DATE UNDERWAY COMPLETED <br /> PRELIMINARY ASSESSMENT U C DATE UNDERWAY COMPLETED <br /> REMEDIAL INVESTIGATION U wf. DATE UNDERWAY COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACT TAKEN Y N ENFORCEMENT TYPE 1 2 3 4 5 6 DATE ACTION TAKEN <br /> LOFT CONSIDERATION 9 2 3 H S C A R W G 0 <br /> EXCAVATION STARTED CASE CLOSED Y R H DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD C8 ED ET FP GT IT RS HU NA VS <br /> _Primary / _Additional RESPONSIBLE PARTY <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE 21P <br /> Additional RP's listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> EH 23 083(09/89)REVISED 11/90 89-20(IV)01/90 PILMFA <br />