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;t <br /> APR 19 ;s <br /> r PA!! JOAQUIN COUNTY - ENVIRONMENTAL HEALTHFDI _ON <br />! LOP PROGRAM - MFR INPUT FORM JAN 2 5 199�i <br /> UPDATE �� 3 BY � REVIEWED BY DATE ENTERED <br /> .F BY <br /> ADDITION: EDIT: <br /> ENTERED LOP SJ/PHS CONTACT 6 <br /> IN ii PRIORITY <br /> NOR SENT LOC CODE DIST PROGRAM/ELEMENT CODE + <br /> SITE SPECIFIC QUARTERLY REPORT INFORMATION h <br /> „ E <br /> CONTRACTOR ill 39000 SUBSTANCE #1 r^ x <br /> 2 <br /> SITE CODE (e r SOURCE OF FUNDS S / F FED EXEMPT € Y / N PETROLEUM Y / N k <br /> SITE NAME I DATE REPORTED h{ <br /> ADDRESS 1 <br /> DATE CONFIRMED <br /> CITY" L— CA ZIP MULTIPLE RP's Y / N i <br /> SITE STATUS ; I <br /> CASE TYPE CONTRACT STATUS F al STATUS CHANGE DATES EMERGENCY RESPONSE <br /> U S G D 1 2 3 4 5 S 7 8 , E <br /> RP SEARCH ' S 1, N R DATE UNDERWAY ' <br /> � COMPLETED <br /> PRELIMINARY ASSESSMENT U C DATE UNDERWAY + , COMPLETED ` <br /> REMEDIAL INVESTIGATION U C DATE UNDERWAY COMPLETED { <br /> REMEDIAL ACTION U I C ' DATE UNDERWAY :k COMPLETED ,i! <br /> POST REM ACT MONITORING Y N U C DATE UNDERWAY ,: COMPLETED <br /> a I <br /> ENFORCEMENT ACT 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 4 <br /> I� { <br /> EXCAVATION STARTED CASE CLOSED Y R Com, L DATE CLOSED <br /> d <br /> REMEDIAL ACTION TAKEN CD CB ED ET FP GT IT RS HU k NA VS VE .'NT OT UK <br /> k <br /> Primary / Additional RESPONSIBL6PARTY NOV 2 19 q 8993 <br /> b <br /> k <br /> COMPANY NA14E4 ' ` m C PHONE y: <br /> I <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATEZIP <br /> I <br /> � F <br /> Additional RP's listed on REVERSE SIDE CONTAMINATED MFR INFO on REVERSE SIDE <br /> EN 23 083(09/89)REVISED 8/92 k 89-20(IV)01/90 PILMFA <br />