Laserfiche WebLink
�h <br /> PHS/SAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DIVISION <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM <br /> UPDATE: / / j BY: REVIEWED BY: DATE ENTERED: <br /> I� SWEEPS/SITE CODE r+� PROGRAM/ELEMENT COMP # LOC CODE DIST # <br /> UGT FILE PILOT FILE H W FILE SITE MITIGATION PWS FILE PRIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O 0 FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> ELEADGNCY/UNIT SJ/EH CONTACTDHS CONTACT <br /> CONTACT RWOCS CONTACT y]I �(1 UDR issued Y / N NPDES issued Y / N <br /> k FAILED P7 SOIL CO T GW COtiT DW CONT ETROIEUM N <br /> J <br /> SUBSTANCE #1 %0 C.& (� #2 #3 94 I #5 <br /> PRIOR FAILED PT NO ACTION CIE AN UP COMPLETE DATE <br /> ENFORCEMENT ACTION Y / N <br /> E <br /> EtIFORCEMENT TYPE: 1 2 3 k 5 b GATE ACTION TAKEN: <br /> IC <br /> SITE NAME r tnoi,S <br /> i ADDRESS LLj-+©� j'I[) 4-(f, <br /> CITY •T��� <br /> STATE ZIP <br /> 4 CONTACT NAME -12 ( f/YL�� PHONE <br /> PROPERTY OWNER <br /> i ' . y pr�1 S I� <br /> COMPANY NAME Z)W eA l Il I o t s �SS PHONE <br /> CONTACT NAME O� �(� ���v 1 PHONE J� �qpN3 <br /> L <br /> ADDRESS <br />! CITY I �' �CJC�� STATE ZEP q <br /> i RESPONSIBLE PARTY (If different from Property Owner) <br /> it <br /> COMPANY NAME PHONE I <br /> h <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE F <br /> ZIP i <br /> F <br /> 'Ip CONSULTANT PHONE <br /> UAR # DATE �,�,�C( PROP b5 # GJ��,(/ ATE g,l PRIORITY <br /> STREET # /Y SITE STREET 1:5 <br /> ��(� APN # (.�b �-{ <br /> EN 23 070 (7/89)REVISED 00/3/91 89-19(IV) CNTMFR2 ` ! 11 <br />