Laserfiche WebLink
PHS JOAQUIN COUNTY - ENVIRONMENTAL HEALTH OIV* <br /> CONTAMINATED SITE 0-Base MFR - INPUT FORM <br /> ............... <br /> UPDATE: By: REVIEWED BY: 1�kp DATE ENTERED: By: <br /> PROGRAM/ELEMENT DIST <br /> SWEEPS/SITE CODE COMP 0 Aj,-J-C) S, LOC CODE <br /> 11q1 I -- d <br /> UGT FILE I PILOT FILE H W FILE SITE MITIGATION PWS FILE PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O j LAND USE FILE EMERGENCY <br /> 0 FILE EPI FILE OTHER AGENCY REPORT RESPONSE <br /> LEAD AGNCY/UNIT SJ/EH CONTACT DNS CONTACT <br /> OTHER CONTACT RU0C6 CONTACT WOR issued Y /(_1) NPOES issued / (k) <br /> FAILED PTCONT GW CONT DW CONT ETROLEUM Y / N <br /> SUBSTANCE #1 1 -� 0 3 L-A L 02 #3 #5 <br /> PRICK FAILED PT � ACTION CLEAN UP COMPLETE DATE ENFORCEMENT ACTION Y�o I t-f <br /> ENFORCEMENT TYPE: 1 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME <br /> CO /7'CL 7"e <br /> ADDRESS <br /> CITY 7'b 1 STATE ZIP t ma c) /I <br /> CONTACT NAME PHONE 310 LI, <br /> PROPERTY OWNER <br /> CCMPANY NAMEPHONE <br /> CONTACT NAME ✓ PHONE -3 <br /> ADDRESS C/ 0 t-3 <br /> STATE <br /> RESPONSIBLE PARTY (if different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE <br /> - I ZIP <br /> CONSULTANT PHONE <br /> GATE PRIORITY� <br /> UAR 0 PROP 65 il 2- <br /> F, <br /> STREET 9 SITE STRE Aht-APN 9 <br /> EN Z3 070 (7/89)REVISEO 03/91 89-19(IV) CNTMFR2 <br />