Laserfiche WebLink
PH&;--A JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVV--;N <br /> LOP PROGRAM - MFR INPUT FORM <br /> [UPDATE a �s J!Yt _ [REVIEWED BYI j <br /> DATE ENTERED A 0 U y <br /> ADDITION• DIT: <br /> ENTERED LOP +� �� S SJ/PHS CONTACT PRIORITY <br /> OR SENT LOC CODE �� DIST 5 PROGRAM/ELEMENT CODE 3 2 7 <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 �6�0 I_�r� 2 3 <br /> SITE CODE 5 6 a— SOURCE OF FUNDS , S / FED EXEMPT Y. / PETROLEW Y / N <br /> SITE NAME .1/ a--i� DATE REPORTED <br /> ADDRESS 2-3 9 b ( 5 DATE CONFIRMED <br /> CITY j n CA ZIP MULTIPLE RP's Y / N <br /> 1 SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U (S G D 1 2 4 5 6 7 8 <br /> RP SEARCH <br /> -/ U I N R DATE UNDERWAY c; -L3 5 COMPLETED <br /> PRELIMINARY ASSESSMENT C DATE UNDERWAY COMPLETED J <br /> REMEDIAL INVESTIGATION 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 ACT TAKEN 0 N �gENFORCEMENT TYPE 2 3 4 5 6 DATE ACTIOG TAKEN <br /> LU FT CO?ISIDERATION 1 2 U U R W G 0 <br /> EXCAVATION STARTED CASE CLOSED l/Y R C L DATE CLOSED ff <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT IT RS HU NA VS VE NT OT UK <br /> G / <br /> Primary / Additional RESPONSIBLE PARTY <br /> COMPANY NAME PHONE -� <br /> CONTACT NAME Jrl ` PHONE (-x0 dQD 'n <br /> ADDRESS <br /> CITY ! STATE 1/l )j I ZIP <br /> Additional RP's listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> EH 23 083(09/89)REVISED 8/92 89-20(IV)01/90 PILMFA <br />