Laserfiche WebLink
Pi,/SAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION <br /> PILOT PROGRAM - MFR INPUT FORM <br /> UPDATE 1L BY /� REVIEWED BY GATE ENTERED , �;.� -;, By <br /> ADDITION: X EDIT: n C <br /> ENTERED PILOT D / SJ-PHS CONTACT T y,� � " SWEEPS G Z PRIORITY / <br /> COMP q LOC CODE (, II DIST 3 2 2 PROG/ELEMENT CODE <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SOURCE OF FUNDS S SUBSTANCE �3 / <br /> SITE CODE Z 16 Z �J FED EXEMPT Y / C_J PETROLEUM / N <br /> SITE NAME DATE REPORTED <br /> ADDRESS 2.r C DATE CONFIRMED <br /> C <br /> QTY �, �' �.� �.1 CA 21P CATEGORY R / <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS EMERGENCY RESPONSE <br /> U S V D 1 2 3 _Y` V 7 8 9 <br /> RP SEARCH ,lY I N R�� DATE UNDERWAY O 7U COMPLETED <br /> PRELIMINARY ASSESSMENT U 1 Com�') DATE UNDERWAYZ 7 COMPLETED <br /> REMEDIAL INVESTIGATION UU /✓ DATE UNDERWAY S /S y 7 COMPLETED <br /> REMEDIAL ACTION /U / 1 C DATE UNDERWAY fr' COMPLETED LS <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACT TAKEN Y N ENFORCEMENT TYPE 1 2 3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 2 Cj U S (C CA') R ( W) (G 0 <br /> EXCAVATION STARTED 7_ S CASE CLOSED Y R H DATE CLOSED <br /> I <br /> REMEDIAL ACTION TAKEN co C8 ED ,ET FP GT IT RS HU NA VS <br /> RESPONSIBLE PARTY <br /> COMPANY NAME <br /> (-e,i (c1 PHONE 6// S) Y�lS- 7G 74 <br /> CONTACT NAME ' o PHONE LIZ <br /> ADDRESS rrll <br /> CITY t _ � {�, ___ ___ STATE `�7 21P �`� d,3 <br /> EH 23 083(09/89)REVISED 01/90 <br /> 89-20(IV)01/90 PILMFR <br />