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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)464-0 13 8 Web: www.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> FSite[D. SDU Existing <br /> OQp2b1 �D Case ID: FRO �a ZO�.S Facility ID: FA Ob��aoz <br /> SITE INFORMATION <br /> Business Name: sGjT-m 1*%1z Phone: <br /> Street#: 08( Dir: Ile Street Name: Hpe. 13VE <br /> City: 5 ,t�� State: g5-2D Z <br /> County: 39—San Joaquin County APN: <br /> CASE INFORMATION <br /> Program Element: Assigned Name: MAINSITE J Kkv <br /> Regulatory Oversight Program: <br /> Funding for Regulatory Oversight: J'' <br /> Funding for Cleanup: <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> Case Type: E] A -Drinking Water Supply Aquifer Affected ❑ F- Surface Water El -Soil Only <br /> ❑ W-Drinking Water Well Affected ❑ U-Undetennined Affected <br /> Beneficial Use: MU N—Municipal and Domestic Supply <br /> Vulnerability Basis: �f <br /> MTBE Threat Classification: MTBE Cleanup Classification: NA <br /> Number of Impacted Wells: 0 Well Impact Description: None O CI� KIVyw /w <br /> CASE MANAGEMENT <br /> Brownfield: ® N—Site is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: ❑ Agricultural ❑ Commercial Industrial ❑ Public Use <br /> ❑ Residential <br /> Exclude from Export "..Leave blank unless PE code is any 2900 sites.-" <br /> Completed By: Jun r—I O, Date: <br /> Entered BY: Date: <br /> EH-29- <br /> 09/18/2007 <br /> H-29- <br /> 09/l8/2007 <br />