Laserfiche WebLink
PHS/SAID JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION <br /> CONTAMINATED SITE D-Base MFR INPUr FORM <br /> UPDATE: 97 BY: `— � REVIEWED BY: DATE ENTERED: / / BY: <br /> SWEEPS/SITE CODE j ll PROGRAM/ELEMENT COMP # LOC CODE DIST # <br /> UGT FILE PILOT FILE H W FILE SITE 141TIGATION PWS FILE PR1V WELL FILE ENV ASSESS <br /> SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORTTTERGENCY RESPONSE <br /> —L <br /> LEAD AGNCY/UNIT K IJJ C SJ/EH CONTACT �� LCONTACTOTHER CONTACT RWOCB CONTACT WOR issuedNPDES issued Y / <br /> FAILED PT SOIL CONT � ��)� I GW CONT I/v2' ! DW CONT PETROLEUM Y / N <br /> SUBSTANCE #1 ')qlj f 1✓ #2 ��l��i(�� j #, #4 #5 <br /> PRIOR FAILED PT NO ACTION CLEAN UP COMPLETE DATE ENFORCEMENT ACTION Y / N <br /> ENFORCEMENT TYPE: 1 2 3 4 5 6 DATE ACTION TAKEN: <br /> SITE NAME <br /> ADDRESS <br /> CITY � C � .�^ � STATE ZIP <br /> CONTACT NAME •I✓� Or PHONE <br /> PROPERTY OWNER <br /> COMPANY NAME PHONE <br /> G� <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> RESPONSIBLE PARTY (if different from Property Owner) <br /> COMPANY NAME PHONE <br /> CONTACT NAME �J PHONE 75 C <br /> ADDRESS <br /> CITY �`_f� / �// STATE ZIP <br /> CONSULTANT PHONE <br /> UAR # DATE PROP 65 # DATE I �j 7j PRIORITY <br /> STREET # SITE STREET N �y APN # <br /> Ll <br /> EH 23 070 (7/89)REVISED 03/91 89-19(IV) CNTMFR2 <br />