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PHS/SAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION <br /> LOP MFR SIDE A - ADDITION: _DIT: <br /> UPDATE 3Y REVIEWED 3Y DATE ENTERED / / <br /> ( J ( 3 IV/ll <br /> ENTERED LOP SJ/PHS CJNTACT EPROG/ELEM! <br /> E r (/ <br /> l/l./ PRIORITY <br /> NOR SENT. LOC CODE SUPR DIST L Gj] <br /> J ✓C/ S4DR Y / N NPDES Y / N <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR n 39000 SUBSTANCE $I 2 3 <br /> 4 5 <br /> SITE CODE �G� �SOURIM- OF FUNDS S / F FED EXEMPT Y <br /> ✓✓VV / N �.rTROLh"UM Y / N <br /> SITE NAME <br /> DATE REPORTED <br /> .ADDRESS <br /> _-7— - �) <br /> DATE CONFIRMED <br /> CITY <br /> CA ZIP MULTIPLE R.D's Y / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS C3ANGE DAT' �RG'c�'ICY RESPONSE <br /> U S G 0 1 2 3 4 5 6 7 8 <br /> RP SEARCH S I N R DATE UNDERWAY CCMPLZ`Tr-D <br /> PRMIMINARY ASSESSMENT U C DATE UNDERWAY CCMPLh"Tu7 <br /> REMEDIAL INVESTIGATION U C DATE UNDERWAY COMPLETtyD <br /> REMEDIAL ACT=ON U I C DATE UNDERWAY COMPLz-TED <br /> POST :REM ACS MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCMI[ENT ACT TAKEN Y N ENFORCEMENT TYPE L 2 3 4 5 6 DATE ACTON TAKEN <br /> LUFT CONSIDERATION 1 2 3 H S C A R <br /> EXCAVATION STARTED / / CAME CLOSED Y R C L DATE CLOSED / / <br /> REMEDIAL ACTION TAKEN_ CS ID Zr FP GT IT RS 3U NA VS VE NT OT UK <br /> SITE AND FILE STATUS <br /> DEPTH TO WATER GRADIENT WELLS NEARBY X500 eT X1000 FT T-2000 eT TYPE IR DOM PUB <br /> :.1ST SAMPLING DATE FLr1G DATE CAR PROP65 4 <br /> CONTAMINATED SITE MFR - Addi.tion: edit: DATE <br /> UGT FILE I FAILED PT / / SOIL CONT / / 47A CONT / / OW CONT <br /> CONSULT CONTACT RWQC3 CONTACT TSC CONTACT' <br /> TREET SITE STREET APN <br /> S <br /> PROPERTY OWNER(S) AND ADDITIONAL RP'S NOTED ON SIDE 3 Y / N <br />