Laserfiche WebLink
PHS/S��AGJIN CCUNTY • E!iVIRCHMENTAL HEALTH DIVES( <br /> CCNTAMINATEO SITE 0-3ase MFR - INPUT FORM <br /> LIPOATE: 7/3 / 3T:.{� ' REV I E'fa 3Y: dAi c' $!ITERED: /J z / g L ay: � <br /> S4cEPSIS I Tc" C"AE PRGGRAM/-eLEMENr COMP 611 C w LOC CODE D I ST x <br /> UGT FIL° PILOT FILE H V FILE SITE MITIGATION PVS FiLE ?RIV YELL FILE ENV ASSESS k <br /> SOLM VASTEH2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT =.'�ERGENCT RESPONSE <br /> LEAD AGNCYMI I T (3 SJ/EH CCliTACTU`ti �I a S DNS CONTACT -- <br /> 'I <br /> OTHER =TACT XWOC3 CCNTACT S.flR iss�'ed T / N NPOES issued Y / V <br /> 'AM-0 ?T f SOIL CONT '~�4' W CONT Oil CONT ETROLEUbt Y / N <br /> suesTAHCE I -"T /a <br /> MCR FAILED ?T NO ACTION I CLAN UP CWL:TE DATE ENfORC_MENT ACTION Y / N <br /> IIII <br /> ENFORCEMENT TYPE: 2 3 4 5 6 DATE ACTION TAXEN: <br /> F <br /> SITE NAME <br /> l q <br /> CITY L STATE i C LIP L <br /> NAME <br /> [C- <br /> :-.A <br /> CT <br /> I,cJ i ( �-�•v�J f� mile dao`t 131 - 197 14 <br /> PRCPE;TY CLINER <br /> COMPANY NAME PHONE <br /> CCHTACT NAME h hPHCHE <br /> I <br /> ADDRESS 1 4 <br /> CLTY 1111 STATE I ZIP <br /> III <br /> RES?CHSteLS PARTY (If different from Property Ow*r) <br /> CWANY NAME PHONE J <br /> CONTACT NAME PHONE <br /> AOORESS <br /> CITY STATE ZIP <br /> i <br /> Lc:xSULTAN7T PIMME <br /> LIAR --, j �F DATE �, 9� �v PROP 55 xf72 _ /3.]. OA; -.E7� .. PRICRIT7 <br /> STREET 3 I"L ! I SITE STREET APN <br /> Flo <br /> i <br /> d <br /> - <br /> EH 23 070 (7/8911)REvI SE-3 C3/91 a9- 9(IV) C..MTMFR2 <br />