Laserfiche WebLink
TY <br /> OIV <br /> ✓ 2 PHS/SA`CONTAMINAT DN SITE OHBaseNMFRTAIIN£PTHORM [SIO , R o 1993 <br /> UPOATE: !` / / L�ZBY: REVIEWED BY: GATE ENTERED: / / BY: 1-11) <br /> SWEEPS/SITE CODE` 2r I PROGRAM/ELEMENT CCMP LOC CODE D/ DIST —32 <br /> UGT FILE PILOT FILEH W FILET- SITE MITIGATION PWS FILE PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE ` <br /> LEAD AGNCYNNIT �j D� SJ/EH CONTACT � DHS CONTACT ' <br /> OTHER CONTACT ' r RWOC3 CONTACT ,/) WDR issued Y / N NPOES issued Y / N <br /> FAILED PT SOIL CCNT GW CCNT / O CJO OW CONT ETROLEUM �/ N <br /> SUBSTANCE 1 D � x2 33 4 x5 <br /> PRIOR FAILED PT NO ACTION CLEAN UP COMPLETE DATE ENFORCEMENT ACTION N <br /> ENFORCEMENT TYPE: O 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME <br /> ADDRESS <br /> 04 <br /> CITY [STATE ZIP <br /> CONTACT NAME I PHONE <br /> PROPERTY OWNER <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE yo <br /> ADDRESS _ AJ _1&x _ r <br /> CITY NATE ZIP <br /> 111 / .. .. <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CCNSULTANT PHONE <br /> UAR 9 GATE PROP 65 X DATE PRIORITY <br /> STREET SITE STREETf f"/C� APN , <br /> / ,i �r <br /> EH 23 070 (7/89)REVISED 03/91 89-19(IV) CNTMFR2 !llcccJJJ <br />