Laserfiche WebLink
PHS,,,.A JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIV:,...dI <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM <br /> UPDATE: / f / �� BY: REVIEWED BY: DATE ENTERE"d' 1 / BY' <br /> SWEEPS # / 7 SITE CODE g COMP # LOC CODE 161DISTUGT FILE PILOT FILE H W FILE SITE MITIGTION PWS FILE PRIV WELL FILEENV ASSESS <br /> SOLID WASTE H2O C FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT H W SPILL/DISPOSAL <br /> PROGRAM/ELEMENT LEAD AGENCYNNIT �`/� SJ/EH CONTACT <br /> RWOCB CONTACT 6 ` DHS CONTACT OTHER CONTACT <br /> FAILED PT SOIL CONT GW CONT DW CONT PETROLEUM Y / N <br /> SUBSTANCE #1 #2 #3 1 #4 #5 <br /> PRIOR FAILED PT NO ACTION CLEAN UP COMPLETE DATE ENFORCEMENT ACTION Y / N <br /> ENFORCEMENT TYPE: 1 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME PHONE <br /> ADDRESS <br /> CITY STATE -y7,o ZIP �D <br /> CONTACT NAME ��C'�!� W��1�Ie1 ONE r16 <br /> PROPERTY OWNER <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANT PHONE <br /> UAR # DATE PROP 65�#� ,r / DATE PRIORITY <br /> STREET # ©�' SITE STREET <br /> EH 23 070 (7/89)REVISED 01/91 89-19(IV) CNTMFR2 <br />