Laserfiche WebLink
PH'S,, N JOAt1UIN COUNTY - ENVIRONMENTAL HEALTH DIV._.&OW <br /> Side B - LOP PROGRAM - MFR INPUT FORM <br /> UPDATE BY SITE CODE ADDRESS <br /> Primary / y AdditionaL RESPONSIBLE PARTY l �' <br /> COMPANY NAME PHONE <br /> e0N4A@T NAgE WAM PHONE <br /> ADDRESS Sam t10 <br /> CITY STATE to ZIP <br /> Primary / Additionat RESPONSIBLE PARTY <br /> COMPANY HA9E PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> Primary / Additional RESPONSIBLE PARTY <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONTAMINATED SITE MFR - Addition: Edit: <br /> UGT FILE FldLED PT / / SOIL CONT Z /Z Z /09GU CONT / / DW CONT Y / N <br /> PROPERTY OWNER <br /> COMPANY NAME PHONE <br /> ,CD�T NAME rT • > N t, PHONE <br /> ADDRESS <br /> CITY 1 ^\ I STATE tA I ZIP q <br /> CONSULTANT PHONE <br /> RWGCB CONTACT LIAR # Illy DATE: L� <br /> PROP 65 # �� ' I's Z DATE: <br /> DHS CONTACT <br /> WDR issued: Y / N NPDES issued: Y / N <br /> STREET # `k-p SITE STREET LOW SAC2aMMp � APN n A LqD <br /> DTI MFP AP!/�A...# CAC1 J i7 <br />