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Site Identification Form (SII') <br /> (See LEA Advisory No. 3 -for Guidance) <br /> Initial I.D. (Y/N) I Y Date of Field Visit 5/26/11 Follow-up Investigation(Y/N) <br /> Site Information: <br /> Name Ripon Dump AKA <br /> County San Joaquin Nearest Town/City Ripon <br /> Site Address ,1222S. Acacia St. SWIS # 39-AA-0007 <br /> Zip 95366 A 25933007 <br /> Latitude: Degree Minute Second GPS <br /> Longitude: Degree Minute Second L I Map <br /> Land Owner Information: <br /> Land Owner Name City of Ripon Sanitary District <br /> Address 259 N. Wilma Ave. <br /> City Ripon State I CA Zip 95366 <br /> Phone Fax <br /> Site Specifications: <br /> Dates of Operations Closure Date <br /> Closure Plan (Y/N) N Date of Closure Plan <br /> Inspection Frequency Quarterly I Date 6/09/2011 <br /> Inspection Frequency Reduction Request(Y/N) N I Date of Request <br /> Tracking System ApprovedDate of Approval <br /> Site Type: 2136 Burn Dump Illegal Dump Site Other <br /> Site Category: I A B X C D Category Date <br /> Surrounding Land Use: Commercial Residential Industrial X Other Wastewater <br /> Treatment Plant <br /> Comments/Recommendations: <br /> EHD recommends increasing inspection frequency to quarterly in accordance with Title 14 Section <br /> 18083 (a) (4). <br /> LEA Staff Name I Benjamin Escotto Signature AA, Date $1 <br /> CIWMB STAFF ONLY: <br /> Reviewed By Date <br /> Enter bi To SWIS By Date <br />