Laserfiche WebLink
-PHS4�JOAQUIN COUNTY ,,ENVIRONMENTAL HEALTH DIVIQ <br /> LOP PROGRIW - MFR INPUT FORM <br /> UPDATE IO BY REVIEWED BY DATE ENTERED D � BY <br /> ADDITION: ' EDIT: <br /> / k , <br /> ENTERED k4O /0/&/17-b SJ/PHS CONTACT /, •`; PRIORITY <br /> -.J <br /> NOR SENT i LDC CODE D15T Z� , . PROGRAM/ELEMENT CODE <br /> SITE SPECIFIC QUARTERLiEREPORT INFORMATION <br /> ,F <br /> CONTRACTOR # 39000 SUBSTANCE #1 <br /> SITE CODE b SOURCE OF FUNDS S /} s., FED EXEMPT T / N .? PETROLEUM Y / N I <br /> II <br /> SITE NAME " DATE REPORTED 4 <br /> ADDRESS ! .� _ 0_� DATE CONFIRMED <br /> i C�rz ,o. <br /> CITY CA ZIP ��3 MULTIPLE RP's Y / oil <br /> SITE STATUS <br /> CASE TYPE CONTRACT STATUS `` STATUS CHANGE DATE EMERGENCY RESPONSE <br /> UOSG D 1 2 3� 4 5 7 , 8 4 <br /> RP SEARCH S I N R DATE UNDERIJAY COMPLETED <br /> PRELIMINARY ASSESSMENT U C `;DATE UNDERWAY COMPLETED <br /> REMEDIAL INVESTIGATION U C 'DAUNDERWLY COMPLETED <br /> TE� <br /> REMEDIAL ACTION U 1 , C �iDATE:' NDERWLY COMPLETED <br /> 6 <br /> e <br /> POST REM ACT MONITORINY N U C yDATE ;UNDERWAY COMPLETED <br /> G <br /> i <br /> ENFORCEMENT ACT TAKEN N ENFORCEMENT TYPE r �✓ 2 3- 4 '5 6 DATE ACTION TAKEN <br /> LUFT CONSIDERATION <br /> CJI 0 � O C,5� „� - � 11 O <br /> EXCAVATION STARTED Fc A7UOSED Y R H DATE CLOSED <br /> REMEDIAL ACTION TAKEN CD .CB ED ET`i`. FP- - GT IT RS i' HU HA VS <br /> Primary./ . AddIt16naL RESPONSIBLE PARTY.. <br /> COMPANY NAME <br /> C G 'L'Lvn K� V JW Ae�J l.C� • PHONE r <br /> CONTACT NAME PHONE I <br /> ADDRESS ] /i s L s <br /> t r :i tae Ki <br /> CITY � G CC tz STATE ZIP c?SZG�B <br /> Additional RP's Listed on REVERSE SIDE. Jr 5 CONTAMINATED HER INFO on REVERSE SIDE <br /> EN 23 083(09/89)REVISED .11/90 89-20(IV)01/90 PILMFA <br /> i ; <br />