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PHS,..., JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVi� <br /> LOP PROGRAM - MFR INPUT FORM <br /> UPDATE / 2-2- -7 Z BY td REVIEWED BY DATE ENTERED / /�A� 3 1 <br /> BY <br /> ADDITION: EDIT /-,"/ <br /> - <br /> ENTERED PILOT �� QD SJ/PHS CONTACT ?VA SWEEPS ! PRIORITY <br /> NOR SENT -c !!f!!f !!!"'h LOC CODE DIST 3Z� PROGRAM/ELEMENT CODE <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR * 39000SUBSTANCE 01 ���/6 <br /> SITE CODE r d SOURCE OF FUNDS S / F FED EXEMPT Y ! &,J PETROLEUM Y ! N <br /> SITE NAME SJ �� DATE REPORTED -7/1 <br /> b J <br /> ADDRESS DATE CONFIRMED 3 } �+��' <br /> CITY Q LLLJ CA 2IP I �_�sMULTIPLE RP's Y / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U So G D 1 2 3 5 7 8 1 <br /> RP SEARCH I N R DATE UNDERWAY , COMPLETED c D <br /> PRELIMINARY ASSESSMENT U C DATE UNDERWAY y p COMPLETED 2Z2q <br /> REMEDIAL INVESTIGATION U DATE UNDERWAY COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACT TAKEN �Y N ENFORCEMENT TYPE 1 2 3 5 6 DATE ACTION TAKEN <br /> LOFT CONSIDERATION ( 1) 2 3 / H J OOA" <br /> R iI G 0 <br /> EXCAVATION STARTED Z�., O CASE CLOSED Y R H DATE CLOSED q1 <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT IT RS IIID NA VS <br /> Primary / Additional RESPONSIBLE PARTY !! <br /> COMPANY NAME a-M; ,�_ CoPHONE d�1 ) i G �_�S�U O <br /> CONTACT NAME 1� kl&�� PHONE zb1/ 1-1 „ O <br /> ADDRESS b `f , <br /> Ci TY S.� (h �-;^ iJ� STATE ZIP' �j <br /> Ei <br /> tion�L RP's listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> EH 23 083(09/89)REVISEO 11/90 89-20(IV)01/90 PILMFA <br />