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Site Identification Form (SIP) <br /> (See LEA Advisory No.3 -for Guidance) <br /> Initial LD.i(Y1N)! NDate,of Field Visit 12/30/2010 " Follow-up:Investigation(Y/N) N <br /> Site Information: <br /> Name Snyder Sanitary Garbage Disposal Site AKA Lynch and Bill Lane Dump <br /> County San Joaquin Nearest Town/City ,. Stockton <br /> Site Address S23 T2s Me Mdb&M,Escalon,CA SWIS# ' 39-CR-0031 <br /> Zi 95320 APNn 249-060-13; 249-060-14; 249-060-12; <br /> p <br /> 249-060-10. <br /> Latitude: Degree,`; IVlmute, Second GPS <br /> Longitude:. Degree; 1Vhrute T 36co% nd Map <br /> Land Owner Information: <br /> Land Owner Name' 1. Peter Palomino. 2.Bruce Beard.3.Richard L. Evans, aka Mick Evans. <br /> Addre% ss'% 1. 23023 S. Santa Fe Rd., Escalon, CA 95320. 2. 23021 S. Santa Fe Rd., <br /> Escalon, CA 95320. 3. 23701 S. Santa Fe Rd., Escalon, CA 95320. 4. 22865 S. <br /> Henry Rd.,Escalon, CA 95320. <br /> City State Zip <br /> Phone Fax <br /> Site,S ecations '�� �� ` <br /> Dates of Operations: N/A Closure Dats�e <br /> CIosure:Plan(Y/ T N Date o Closure,Plan <br /> Inspection Frequency; quarterly2/30/2010 <br /> Inspe"coon Frequency Reduction Request;(Y/N). N `"Date of Requests' <br /> Trackmg"Systerii"Approved `', Date of Approval;` ,, <br /> Site Type: 213,6 Burn"Dumpx ``11legal Dump,Site"`' x Other: CIA site <br /> Site Category: A B C: D. Category Date; <br /> Surroundin Land.Use` ' Coim"'i cial x .Residential `Industrial ' x Other; Agricultural <br /> Comments/Recommendations: <br /> EHD is recommending a change in the inspection frequency for this site from annually to quarterly in <br /> accordance with Title 14 California Code of Regulation, Section 18083 (a)4. <br /> LEA Staff Name I Natalia Subbotnikova i`nature -;�Late <br /> CIWMB STAFF ONLY: <br /> Reviewed By Date' <br /> Enter"In To SWIS By Date <br />