Laserfiche WebLink
/ P. JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DI <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM <br /> Y <br /> UPDATE: /� / > / BY: REVIEWED BY: AVDATE ENTERED: /_ Ij / CJ BY: <br /> SWEEPS/SITE CODE PROGRAM/ELEMENT CCMP d LOC CODE !/� DIST 3 <br /> UGT FILE PILOT FILE H W FILE SITE MITIGATION PWS FILE PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> LEAD AGNCY/UNIT (,(�(� L T3 SJ/EH CCNTACT �� DHS CONTACT - <br /> OTHER CONTACT RWQCB CONTACT WDR issued Y / N NPOESissued Y / N <br /> FAILED PT SOI CONT l 2- 5 /J/ GW CONT OW CONT ETROLEUM Y N <br /> SUBSTANCE #1 12-0 3 C/ 92 ((( #3 $5 <br /> -T- <br /> PRIOR FAILED PT NO ACT/ION CLEAN UP COMPLETE DATE JENFORCEMENT ACTION TY <br /> / N <br /> ENFORCEMENT TYPE: 1 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME - - <br /> ADDRESS 3 9 <br /> --7CITY STATE Z(P <br /> CONTACT NAME PHONE <br /> PROPERTY OWNER <br /> COMPANY NAME 1 PHONE S Q <br /> t <br /> CONTACT NAME PHONE <br /> ADDRESS 3/5'F ��:GtJ(iTJ <br /> CITY STATE C ZIP g✓d <br /> RESPONSIBLE PARTY (If different from Property Owner) [ <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANT _ PHO E <br /> UAR X DATE PROP 65 # Z�S DATE �Z/S/'g� PRIORITY O <br /> STREET /) SITE STREETYZ //APN <br /> EH 23 070 (7/89)REVISED 03/91 89-19(IV) CNTMFR2 <br />