Laserfiche WebLink
PHSOJOAQUIN COUNTY - ENVIRONMENTAL HEALTH DTVI <br /> CONTAMINATED SITE D-Base MFR - INPUT FORM <br /> UPDATE: /C,& BY: 'v�"IG REVIEWED BY: A DATE ENTERED: / / BY• <br /> SWEEPS/SITE CODE 90PROGRAM/ELEMENT !�5-0— COMP <br /> # LOC CODE fff� DIST <br /> UGT FILE PILOT FILE H W FILE SITE MITIGATION PWS FILE RIV WELL FILE ENV ASSESS <br /> SOLID WASTE H2O D FILE EPI FILE LAND USE FILE OTHER AGENCY REPORT EMERGENCY RESPONSE <br /> LEAD AGNCY/UNIT C/�Q SJ/EH CONTACT /J/Ji � . DHS CONTACT - -- <br /> OTHER CONTACT RWOCB CONTACT WDR issued Y / N NPDES issued Y / N <br /> FAILED PT SOIL CONT GW CONT DW CONT ETROLEUM Y / N <br /> SUBSTANCE #1 #2 #3 #4 #5 <br /> PRIOR FAILED PT F 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 "7 L STATZIP <br /> / e a <br /> CONTACT NAME ' / HONE IX D/ 9'L16_ j� <br /> PROPERTY OWNER <br /> COMPANY NAME n j HONE <br /> CONTACT NAME // „ / O O HONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> RESPONSIBLE PARTY (if different from Property Owner) / ^C <br /> COMPANY NAME HONE <br /> CONTACT NAME PHONE <br /> ADDRESS <br /> CITY STATE ZIP <br /> CONSULTANT / .L HONE 9//_ /^70 <br /> UAR # LLL DA/TE PROP 65 # DATE I(b PRIORITY <br /> STREET # SITE STREET APN # <br /> EH 23 070 (7/89)REVISED 03/91 89-19(IV) CNTMFR2 <br />