Laserfiche WebLink
PHS/SAN *QUIN COUNTY — ENVIRONMEN10 HEALTH DIVISION <br /> CONTAMINATED SITE MFR — INPUT FORM <br /> UPDATE 'c9 /ZSyO BY I < A REVIEWED BY DATE ENTERED / /c BY <br /> t/V � /Zy 'd <br /> ADDITION. EDIT <br /> SWEEPS # 216 COMPUTER # �I��T6 DIST # 3 zZ LOC CODE <br /> UGT FILE H W FILE LAND USE FILE F'WS FILE PILOT FROG <br /> FAILED PT / / SOIL CONT �/ / �O GW CONT / / DW CONT <br /> PETROLEUM &/ N ENTERED PILOT /Q / �/ s/qU PROG/ELEMENT <br /> SITE NAME 11D <br /> ADDRESS PHONE <br /> CITY <br /> c Ic STATE CA ZIP <br /> SZc�7 <br /> CONTACT NAME art 1� CROSS STREET U<oY)lhyl0o <br /> PROPERTY OWNER <br /> NAME PHONE <br /> `-IY �- 17� I <br /> MAILING/STREET ADDRESS Jf <br /> CITY SSC- /41 STATE �� ZIP SzC� <br /> CONTACT NAME C PHONE <br /> 7 5 3 '7 <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME S;z -0 9� �,� / PHONE <br /> CONTACT NAME / P ONE -SS77 <br /> ADDRESS <br /> CITY STATE ZIP <br /> WCONTACT <br /> PHONE <br /> G <br /> O <br /> OTHER CONTACT <br /> UAR # — DATE 7 PROP 65 # 5 b C)l DATE 7 /zs / <br /> STREET # SITE STREET <br /> ��� G— I � PRIORITY <br /> EH 23 070 (7/89) 89-19 ( IV) 7/89 CNTMFR <br />