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Site Identification Form (SIP) <br /> (See LEA Advisory No. 3 -for Guidance) <br /> Initial ID. (Y/N) Y Date of Field Visit 5/14/2010 Fellow up Investigation(Y/N}`'» N <br /> Site Information° ~" <br /> Name Prima Frutta Packing, IncAKA <br /> "`County, San Joaquin Nearest:Town!City Stockton <br /> :Site Address `` 16461 E. Comstock Rd.,Linden, CA SWIS# 39-AA-0052 <br /> 'Zip 95236 :APN: 06520003 <br /> Latitude ;Degree,, Minute Second GFS <br /> Longitude:' `]D6g I Minute Secnd Map <br /> Land Owner Information: <br /> Land Owner Name Tim Sambado <br /> Address 16461 E. Comstock Rd <br /> City Linden State CA Zip95236 <br /> Phone (209) 931-1460 Fax 1 (209) 931-1466 <br /> $4e,Secirk ations .. <br /> Dates of Dperaiions :' seasonal ' Closure'Date <br /> Closure Plan(Y/N) N Date ofv.Closure Plan.' <br /> Inspection Frequency annually Date 5/14/2010 <br /> Inspection Frequency:Reduction Request;.(Y/N) ,., N I iiPate of Request <br /> 'Track ing System Approved£; Date oiApprov„al, 11 <br /> Site Type: 2136 B*,,Durnp Illegal Dump Site' x Other '” exempt <br /> Site Category:` -1-A] B ( D ategory:Date `„, <br /> Surroundiri Land Use:,' Commercial Residential Industrial i I x Other I agricultural <br /> Comments/Recommendations: <br /> Exempt <br /> LEA Staff Name Natalia Subbotnikova Signature %g Date <br /> CIWMB STAFF ONLY: <br /> Reviewed By: Date <br /> Enter In To SWIS By Date' <br />