Laserfiche WebLink
PHS JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DTVI <br /> LOP PROGRAM - MFR INPUT FORM <br /> I UPOA7E10- ! BY i REVIEWED BY ` �1 DATE ENTERED lj/ BY <br /> _ 3ADDITION: EDIT: 77 <br /> ENTERED PILOT 'l 3D�Li') SJ/PHS CONTACT A4. I NFU R Al /1 I <br /> SWEEPS # � — PRIORITY <br /> NOR SENT LOC CODED/ DIST ( PROGRAM/ELEMENT CODE1 <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 jfWjt.1q z 45 <br /> SITE CODE /Z SOURCE OF FUNDS S / FED EXEMPT Y / ON PETROLEUM / N <br /> SITE NAME Ti�iP,FT QED SS��Z DATE REPORTED 7-2 <br /> 9 -V <br /> ADDRESS '7// Y 7 Ak e/ .L,C 4 v� <br /> + DATE CONFIRMED ?_ 3 0 I <br /> CITY v�_ iC.IC �N/ CA ZIP '?52 0 MULTIPLE RP's Y / <br /> 5 SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U S G� D 1 2 3 05, 7 8 9 <br /> RP SEARCH I N R DATE UNDERWAY 7 30 , COMPLETED <br /> PRELIMINARY ASSESSMENT ( C C DATE UNDERWAY '� ' COMPLETED -7130191 <br /> REMEDIAL INVESTIGATION (U 1 �9(G DATE UNDERWAY -7/3t) l 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 N ENFORCEMENT TYPE C1� 2 3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 2 (D 0 a © (3) R © `:J 0 <br /> EXCAVATION STARTED CASE CLOSED Y R H I DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT IT RS HU NA VS <br /> Primary / _Additional RESPONSIBLE PARTY D <br /> COMPANY NAME DSC /J7' �/ PHONE <br /> CONTACT NAME T�12 PHONE <br /> tL0 <br /> ADDRESS /O OO Q d, <br /> CITY STATE ZIP 9oa �o <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 />