Laserfiche WebLink
PHS/SAN JL. JUIN COUNTY - ENVIRONMENT HEALTH DIVISION <br />CONTAMINATED SITE MFR - INPUT FORM <br />UPDATEI/z/5"/0 <br />, <br />BY Af?.. <br />1 <br />REVIEWED BY <br />.J. <br />)- <br />0,41/ DATE ENTERED / / BY <br />ADDITION: EDIT: <br />SWEEPS # /222. COMPUTER # et ?Li ? /3 DIST # 232 LOC CODE <br />UST FILE VII W FILE LAND USE FILE PWS FILE PILOT PROS <br />FAILED PT / / SOIL CONT /2/,x-/c5;6 SW CONT <br />, <br />/ / DW CONT <br />PETROLEUM 6)/ N ENTERED PILOT / / PROS/ELEMENT <br />SITE NAME <br />, <br />ADDRESS /34_7(0 to. to179-54//4.)/'7%---77),6 PHONE <br />r <br />, Cza0 9 civ-...."5- <br />CITY <br />I <br />(77:.)(-±<7.7.)-Al <br />STATE CA ZIP <br />r <br />SZD3 <br />CONTACT NAME -).-Ci.) CTZ)itY-7_1--(_- CROSS STREET -='/A4 <br />PROPERTY OWNER <br />NAME (") <br />I7.z.- t.-.7),P7e F'2 r,c/c---/ -. <br />PHONE <br />MAILING/STREET ADDRESS TO, 7,3Cy 52? <br />CITY STATE re ZIP <br />CONTACT NAME kIi Ga_vy7/3,--z, PHONE <br />RESPONSIBLE PARTY (If different from Property Owner) <br />COMPANY NAME sl p- PHONE <br />CONTACT NAME PHONE <br />ADDRESS <br />CITY STATE ZIP <br />CONSULTANT PHONE <br />SJ/EH CONTACT <br />RWQCB CONTACT <br />DHS CONTACT <br />OTHER CONTACT <br />UAR # cro -) c) :,........DATE i re? / tr-V gDPROP 65 *7b -.T.Is DATE -77 <br />STREET # /3469 SITE STREET /cipC4.0)61,-TnAi PRIORITY <br />EH 23 070 (7/89) 89-19(IV)7/89 CNTMFR