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SITE IDENTIFICATION FORM <br /> (Attach additional description or explanation as needed.) <br /> Initial I.D.(Y/N):_- Date of Field Visit: 12/21/98 Follow-up Investigation(Y/N): I n <br /> SITE INFORMATION <br /> Site Name: Southwest Hide Company AKA: <br /> SWIS#: case2664 County: San Joaquin-39 APN: 243-240-04 <br /> Location: 11651 E.Palm Lane Manteca Lat/Long' <br /> (Include Location,Township,Range,and Section,and a Parcel Map or a Quadrangle Map'w(rownship,Range,and Section,also include latitudeand longitude) <br /> Land Owner(s): Girdner,Paul k and K <br /> Address: 250 S.Beechwood#180 <br /> City: I Boise I State: I ID Zip: 183709 Phone: <br /> Types of Waste: ❑ Inert ❑ Residential ❑ Commercial ❑ Industrial ❑ Hazardous ® Liquid <br /> Site Type:' ❑ ,Illegal Disposal ❑ Landfill ❑ Burn Ash Site ❑ Treatment Unit ❑ Codisposal <br /> Disposal Area(Acres): SWP Date: WDR Number: <br /> Site Status: Dates of Operations: I ukn <br /> Closure Approved By: <br /> LAND USES w/in 100©ft. w/in 1 mi. of waste boundary <br /> YES NO YES NO COMMENTS <br /> Rural: ❑ ❑ ❑ ❑ <br /> Agricultural: ® ❑ ® ❑ Site is surrounded by agriculture <br /> Residential: ❑ ❑ ❑ ® There is a home for the caretaker on site. <br /> Commercial ❑ ❑ ® ❑ <br /> Industrial: ® 1 A portion of the facility is used for industrial purposes. <br /> Environmentally Sensitive: ❑ ❑ ❑ ® Agriculture. <br /> Water Supply Wells: ® ❑ ❑ ❑ Site is served by a well <br /> Surface Water Bodies: ❑ ❑ ❑ <br /> Inhabitable Structures: ® ❑ ❑ ❑ <br /> Enclosed Structures: ® ❑ ❑ ❑ <br /> Planned Irnprovements: ❑ ® ❑ ❑ <br /> OBSERVATIONS <br /> Surface Condition:' graded <br /> Landfill Gas: I none <br /> Leachate:' none <br /> Bum Ash:''_'' none <br /> Other: The site is a Regional Board site.The site does not appear to be used as a land fill. <br /> All information that I have found supports the idea that the site was not used as a land fill. <br /> RECOMMENDATIONS <br /> Emergency Response: Inone needed <br /> Other Action(s). <br /> Reassess Site?(Y/N/NA): Ino No Further Action?(D,U,X Category Y/N):' D <br /> Priority for Slte Assessment'(High/Med/Low): low <br /> Prepared By: Robert McClellon Date:' 12-29-98 <br /> Reduced Inspection Frequency Approved(YIN): Frequency Date: <br /> CIWMB Remediation,Closure,and Technical Services Branch Revised October 1998 <br />