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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> SITE REMEDIATION INFORMATION <br /> Site ID: SD 0O0'' ^� I Case ID: RO�_W o 0 Existing FA <br /> Zo FacilityID: <br /> SITE INFORMATION <br /> Business Name: 7_P& v o6 t— Phone: <br /> Street#: 32q Dir: C Street Name: Type: 5"'we-T <br /> City: TQ N!I State: Zip: <br /> County: 39—San Joaquin County APN: <l0 <br /> CASE INFORMATION <br /> Program Element: Assigned Name: MAINSITE _f 0Ae,,, <br /> Regulatory Oversight Program: 0 T t-�L <br /> Funding for Regulatory Oversight: I— <br /> Funding for Cleanup: P <br /> File Location: L—Local Agency <br /> RISK MANAGEMENT <br /> ❑ A-Drinking Water Supply Aquifer Affected ❑ F-Surface Water ❑ S-Soil Only <br /> Case Type: <br /> ❑ W-Drinking Water Well Affected U-Undetermined Affected <br /> Beneficial Use: MUN—Municipal and Domestic Supply <br /> Vulnerability Basis: iq <br /> MTBE Threat Classification: MTBE Cleanup Classification: �NA <br /> Number of Impacted Wells: 0 Well Impact Description: None Tk U U mpw& <br /> CASE MANAGEMENT <br /> Brownfield: ON—Si te is not part of Brownfield Site Management Requirements: NA—No Action <br /> Current Land Use: ❑ Agricultural 4 Commercial ❑ Industrial ❑ Public Use ❑Residential <br /> Exclude from Export "Leave blank unless PE code is any 2900 sites." <br /> Completed By: U�9 4(Aly7 Date: <br /> Entered By: ;S Date: <br /> EH-29- <br /> 09/18/2007 <br />