Laserfiche WebLink
PHII'JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DI1O7N <br /> h ':PLOP PROGRAM - MFR INPUT FORM +� <br /> .j <br /> BY <br /> UPDATE ' BY �� REVIEWED BY DATE ENTERED Z <br /> VV I <br /> yiADDITION: EDIT• ' ^ <br /> ENTERED PILOT SJ/PHS CONTACT SWEEPS # - - PRIORITY <br /> a .y <br /> NOR SENT '� LOC CODE DIST` PROGRAM/ELEMENT CODE �� ` <br /> SITE SPECIFIC QUARTERLY REPORT'.INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 -" " ' " ' 5 <br /> SITE CODE 1 j•� SOURCE OF FUNDS S / F FED EXEMPT Y / N PETROLEUM Y / N <br /> SITE NAME DATE REPORTED <br /> ADDRESS Q zf § DATE CONFIRMED <br /> CITY '' CAZIP MULTIPLE RP's Y / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> fs � <br /> U S G D 1 2� 3 {' 4 'S 7 8 9J. <br /> x, 1^ <br /> : I <br /> RP SEARCH S I N R DATE UNDERWAY COMPLETED <br /> PRELIMINARY ASSESSMENT U C'k DATE UNDERWAY COMPLETED <br /> REMEDIAL INVESTIGATION U gtjG ?! DATE UNDERWAY COMPLETED i <br />' REMEDIAL ACTION U I � DATE UNDERWAY COMPLETED .' a,� •�! <br /> POST REM ACT MONITORING " Y N U C DATE UNDERWAY' CCMPLETED�: <br /> ENFORCEMENT ACT TAKEN Y N ENFORCEMENTTYPE 1 2" 3 4 5 ' ^'6 r DATE ACTION TAKEN <br /> I <br /> LUFT CONSIDERATION 1 2 3. T H S' C A� R W G " l p <br /> EXCAVATION STARTED CASE CLOSED f Y R H DATE CLOSED ' S' <br /> 1 <br /> REMEDIAL ACTION TAKEN CD CB' gi 3' ED "`ET FP GT 'IT RS HU •," NA , - VS <br /> Primary / Additional RESPONSISLE PARTY <br /> COMPANY NAME 3' • - w PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS ' � + <br /> CITY !i - ax " f STATE ZIP <br /> Additional RP's Listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE.SIDE <br /> EN 23 083(09/89)REVISED 11/90 " 89°20(IV)01/90 PILMFA <br />