Laserfiche WebLink
` PHSJOAOUIN COUNTY - ENVIRONMENTAL HEALTH DIVI <br /> �CrPROGRAM - MFR INPUT FORM i <br /> UPOATE.. �` BY REVIEWED BY DATE ENTERED <br /> ADDITION: EDIT: <br /> ENTERED PILOT SJ/PHS CONTACT w [SWEEPS # PRIORITY <br /> NOR SENT LOC CODE DIST 2�� PROGRAM/ELEMENT CODEG� Jf` <br /> J 1. <br /> �• II <br /> a SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> h � <br /> i CONTRACTOR # 39000 SUBSTANCE #1 Sb iI 5 <br /> i <br /> SITE CODE 1_ Ca SOURCE OF FUNDS S / F FED EXEMPT Y / N PETROLEUM / N <br /> 11 i <br /> i DATE REPORTED �/ <br /> i SITE NAME (fit / �/}� i� k <br /> g1 <br /> ADDRESS DATE CONFIRMED <br /> h ! -�-�Ve-V n WE II <br /> CITY CMULTIPLE RP's Y / <br /> SITE STATUS <br /> i� <br /> CASE TYPE CONTRACT STATUS I? STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U <br /> U /S/ G D 1 2 3 S 7 8 9 � � � <br /> RP SEARCH S I N R DATE UNDERWAY J7�- COMPLETED�h r a3 l J <br /> PRELIMINARY ASSESSMENT OU <br /> C DATE UNDERWAY fa-��-q� COMPLETED <br /> REMEDIAL INVESTIGATION U Vic- DATE UNDERWAY r COMPLETED <br /> i <br /> DATE UNDERWAY f COMPLETED <br /> REMEDIAL ACTION 1 �j ( <br /> POST REM ACT MONITORING Y O U C DATE UNDERWAY I COMPLETED <br /> I! <br /> � h <br /> ENFORCEMENT ACT TAKEN ( T, N ENFORCEMENT TYPE / 1'J 2 �I3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 3 t S <br /> EXCAVATION STARTED �!a CASE CLOSED Y R H DATE CLOSED C� � <br /> U: <br /> REMEDIAL ACTION TAKEN CD CB ET F? GT iy IT RS HU NA V5 <br /> Primary / Additional RESPONS181LE PARTY <br /> 1 <br /> COMPANY NAME „ f'� PHONE C��i -77 O 1 <br /> vUr l r 1 <br /> CONTACT NAME i PHONE }J <br /> ADDRESS 2j� 0 `I�GrOC�C• "�, F <br /> i <br /> CITY S+b <br /> STATE.I � 2IP �Q <br /> Il <br /> Additional RP's Fisted an REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> di. <br /> ih. EH 23 083(G9/89)REVISED 11/90 ii 89-20(IV)01/90 PILMFA <br />