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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> --TExisting FA <br /> Site ID: SD 000 iL��� Case ID: RO nno��3G Facili ID: <br /> SITE INFORMATION <br /> Business Name: I (jW-U&0X) 11 O(e / 7 I Phone: <br /> Street#: GG 3 Dir: Street Name: Type: Au<- <br /> City: S rwe r! pv' State: Zip: <br /> County: 39—San Joaquin County -APN: <br /> CASE INFORMATION <br /> Program Element: aCf 5-0 Assigned Name: MAINSITE <br /> Regulatory Oversight Program: 07-OL <br /> Funding for Regulatory Oversight: <br /> Funding for Cleanup: R P <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> ❑A-Drinking Water Supply Aquifer Affected ❑F-Surface Water ❑ S-Soil Only <br /> Case Type: <br /> ❑ W-Drinking Water Well Affected U-Undetermined Affected <br /> Beneficial Use: MUN—Municipal and Domestic Supply <br /> Vulnerability Basis: /V <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 0 Well Impact Description: I None OR �Rj KjuGY.tj� <br /> CASE MANAGEMENT <br /> Brownfield: I ®N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: ❑ Agricultural Uf-, Commercial ❑Industrial ❑Public Use ❑Residential <br /> ,Exclude from Export **Leave blank unless PE code is any 2900 sites.** <br /> Completed By: Date: <br /> Entered By: Date: <br /> EH-29- <br /> 09/18/2007 <br />