Laserfiche WebLink
.4jIN COUNTY - ENVIRONMENTAL HEALTH OIVIS:. <br /> CONTAMINATED SITE D-Sase MFR - IN1T FORM <br /> .UPDATE: / / BY: REVIEWED BY: DATE ENTERED � /�,�! � 8Y: <br /> SWEEPSJSI71 COOS PROGRAM/£LEMEN COMP 0 LOC CODE ®r� D15T X 3zm, <br /> UGT FILE PILOT FELE H IJ FILE SITE MITIGATIOEt PWS FILE PRIV WELL FILE ENV ASSESS <br /> -SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> C <br /> i .LF-AO AGHCY/UNIT: S.1/EH CONTACT �� Uy`p` OHS CONTACT <br /> OTHER CONTACX; RIlOCa CQHTACT UCR issued Y / H NPOES issued Y ./ N <br /> FA I LED PT SOIL CONT e7hr/,G GW CONT ON CON7 �ETROLEUM Y J N <br /> SUBSTANCE: #1 x2 !!! S4 <br /> PRIOR FAILED PT TNO ACTION GLEAN UP COMPLETE DATE ENFORCEMENT ACTIOII <br /> ENFORCEMENT TYPE:: 1 2 3 4 5 6 DATE ACT!ON TAAEN: <br /> -SITE NAME 4 6,14� raW <br /> A�DRESS A 4[ <br /> � S • . G v <br /> CITY STI TE ZIP GSD <br /> CONTACT NAME rl/�C 1! PHONE } e-604 Y' <br /> PROPERTY OWNER 1 <br /> COMPANY NAME ! I PHONE <br /> CONTACT NAME - 3313N11 90NE <br /> ADDRESS <br /> CITY STATE ZIP <br /> RESPONSIBLE PARTY (If different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> I <br /> -- i <br /> CONSULTANT PHONE <br /> UAR 9 DATE PROP, 4 # DATE PRIORITY <br /> $SEIEET• # SITE STREET APN f <br /> EH 21070 (7/89)' 89-.19(IV) CNTMF22. REVISED 12I/94 <br />