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CONTAMINATED SITE MFR - INPUT FORM <br /> UPDATE BYJ � , REVIEWED BY DATE E..--ERED ,� BY <br /> ADDITION: EDIT: <br /> SWEEPS # -` COMPUTER # DIST # 32LOC CODE 0/ <br /> UGT FILEffHW FILE LAND USE FILET I PWS FILE PILOT PROG <br /> FAILED PT / / SOIL CONT / / GW CONT � / / DW CONT <br /> PETROLEUM Y / N ENTERED PILOT / / PROG/ELEMENT 2 ZC( <br /> SITE NAMEJ S�0C `tel <br /> ADDRESS PHONE /S - .52 7. yn? <br /> CITY S ��� STATE CA ZIP 9 5"? <br /> CONTACT NAME CROSS STREET <br /> PROPERTY OWNER <br /> NAME e (�4G PHON Z <br /> MAILING/STREET ADDRESS V U r t <br /> CITY C � STATE 0# ZIP y�l�G _23 7S <br /> CONTACT NAME oGVJ G( n - CS PHON /s .5,,-27_ SenS <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME CC) PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS 2�� G ,( /O <br /> CITY /C/xv STATE ZIP CO3 <br /> CONSULTANT S /n �UJ( PHON L/S) So?7- �/Og <br /> SJ/EH CONTACT / <br /> RWQCB CONTACT <br /> DHS CONTACT <br /> OTHER CONTACT <br /> UAR # - DATE / / PROP 65 # 0 DATE / /zZ/1(2 <br /> STREET # Z L SITE STREET �� �r�U/ PRIORITY <br /> EH 23 070 (7/89) 89-19 (IV) 7/89 CNTMFR <br />