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PH.lAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIV,.,3N <br /> LOP MFR SIDE A - ADDITION:__ EDIT:- <br /> UPDATE 13 , / , j-/ BY (/�/( REVIEWED BY DATE ENTERED BY <br /> ENTERED LOP l rSJY`/PHS CONTACT DISK# TY <br /> NOR SENT LOC CODE D I SUPR DIST O p Z PROG/ELEM 35i JJ WDR Y / N NPDES Y / N <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE 41 2 3 4 S <br /> SITE CODE 11//��hI O OURCE OF FUNDS S / F FID EXEMPT I Y / N PETROLEUM - / N <br /> SITE NAME .^-3. bc� -ticv„ Rrn .�+ �J DATE REPORTED <br /> ADDRESS l l I 1 �/-�/ J^ r.-CC_+ 1 /� DATE CONFIRMED <br /> CITY '! f' L tJ CA ZIP 7G�D C. MULTIPLE RP's Y <br /> LLJ (.J l J / N <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CRANGE DATE EMERGENCY RESPONSE <br /> U S G D 1 2 3 4 5 6 ] 9 <br /> RP SEARCt S : N R DATE UNDERWAY COMPLETED <br /> PRELIMINARY ASSESSMENT U C DATE UNDERWAY COMPLETED <br /> REMEDIAL :NVESTIGATT_ON U C DATE UNDERWAY COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT AC: TAKEN Y N ENFORCEMENT TYPE 1 2 3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION 1 2 3 H S C A R W G 0 <br /> EXCAVATION STARTED / / CASE CLOSED Y R C L DATE CLOSED <br /> REMEDIAL ACTION TAKEN CB ED ET FP GT iT RS RU NA VS VE 14T OT UK <br /> SITE AND FILE STATUS <br /> DEPTH TO WATER 4c) GRADIENT WELLS NEARBY x500 FT >1000 FT X2000 7r TYPE IR DOM PUB <br /> LAST SAMPLING DATE FLAG DATE VAR # PROP65 # <br /> CONTAMINATED SITE MFR - Addition:_ Edit:_ I DATE <br /> UGI FILE FAILED PT I SOIL CONT / / GW CONT / / DW CONT Y / N <br /> CONSULT CONTAC' RWQCB CONTACT TSC CONTACT <br /> STREET # SITE STREET APN # <br /> PROPERTY OWNER(S) AND ADDITIONAL RP'S NOTED ON SIDE H Y / N <br />