Laserfiche WebLink
PH51%w,l JOA(UIN COUNTY - ENVIRONMENTAL HEALTH Div..1N <br /> LOP PROGRAM - MFR INPUT FORM <br /> UPDATE 2� Q T BY � � REVIEWED BY DATE ENTERED MAY 0 3 1g g 3 BY <br /> o/ (✓ ADDITION: EDIT: <br /> ENTERED PILOT SJ/PHS CONTACT J FSWEEPS # D/ �� PRIORITY <br /> // f / <br /> NOR SENT L I LOC CODE o f DIST ',t PROGRAM/ELEMENT CODE Z <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION <br /> CONTRACTOR # 39000 SUBSTANCE #1 �035� <br /> SITE CODE /1) SOURCE Of FUNDS S / FED EXEMPT Y / PETROLELMY / N <br /> SITE NAME �1M` K DATE REPORTED j <br /> ADDRESS �j ll�,�/ DATE CONFIRMED <br /> CITY 1 vvC�/I CA ZIP r-fMULTIPLE RP's / <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS STATUS CHANGE DATE EMERGENCY RESPONSE <br /> U (S) <br /> G D 1 2 3 4 5 7 8 9 ' <br /> RP SEARCH CS I N R DATE UNDERWAY '7 COMPLETED <br /> PRELIMINARY ASSESSMENT UU <br /> C DATE UNDERWAY COMPLETED <br /> 1 <br /> REMEDIAL INVESTIGATION U vfl DATE UNDERWAY COMPLETED <br /> REMEDIAL ACTION U I C DATE UNDERWAY COMPLETED <br /> POST REM ACT MONITORING cy <br /> YN U C DATE UNDERWAY COMPLETED <br /> ENFORCEMENT ACT TAKEN � N ENFORCEMENT TYPE �� 2 3 4 5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION1 J"Z 3 H S C AO I R W G 0 <br /> EXCAVATION STARTED J CASE CLOSED Y R H DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT IT RS HU NA VS <br /> Primary / Additional RESPONSIBLE PARTY y , r{ <br /> COMPANY NAME PHONE Cep "Q�d Z <br /> CONTACT NAME / �Za e V? �Y� K�J�/ PHONE �0Q — O�'� <br /> -27 <br /> ADDRESS <br /> CITY STATE ZIP <br /> l� <br /> Additional RPIS Listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> EH 23 083(09/89)REVISED 11/90 89-20(IV)01/90 PILMFA <br />