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COMPLIANCE INFO_2012 - 2014
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0506545
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COMPLIANCE INFO_2012 - 2014
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Last modified
5/20/2019 11:18:53 AM
Creation date
9/24/2018 11:22:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO_2012 - 2014
FileName_PostFix
2012 - 2014
RECORD_ID
PR0506545
PE
2361
FACILITY_ID
FA0007491
FACILITY_NAME
VALLEY PACIFIC FRESNO AVE CARDLOCK
STREET_NUMBER
1524
STREET_NAME
FRESNO
STREET_TYPE
AVE
City
STOCKTON
Zip
95206
APN
16337025
CURRENT_STATUS
01
SITE_LOCATION
1524 FRESNO AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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KBlackwell
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EHD - Public
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-1 « cuic U0.1 f Unnnl UUUUU 0tt1'=ttttt1tttftt0N <br />PAGE 04/30 <br />Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? <br />b. Identify contractor performing decontamination: <br />YES [I No>( <br />Name <br />( _) <br />Address Phone <br />City Zip <br />c, Describe method to be used for decontamination: <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />e, Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone (_� Hauler Reg# <br />Address City Zip <br />Permitted Disposal Site <br />6. a. Describe the method that will be utilized to purge and/or inert +he piping: <br />,r/ i�?lv c'uN�4s,�.•. H ,S�iuc�e.c j�.rti+e .itr/_Cenuve c.v� I <br />b, Piping Hauler: <br />Namerc ei., Phone Z 49 <br />Address /_FSqo _City �cc��v Zip �(P <br />Hauler Registration # (if hauled as hazardous) <br />c, Piping Disposal Site: <br />Name 1:Ve!4 Phone t0 75S_ -q400 <br />Add ress lo isC�o S ri i ll,. A vc- City I'L Zip S(� <br />EPA ID# (if transported to a permitted TSD facility) C- -000 -31 "1 3 era <br />'r. Is the sampling firm an independent third party from the contractor? YES [ j NO [ j <br />a. Identify sampling firm: <br />Name_AAV(J g_,' Phone(70() Y6"%- jon(o <br />Address 063 5" 1� City +-c fa Y, Zip SZ <br />b. Identify laboratory performing analysis: <br />Name l ckC ' �4 e,. phone (-!r� -Z -7 <br />Address — 3 oo City nav,r Zip CA <br />�- <br />8, Describe, in detail, how the soil and/or water $ample(s) beneath the piping or dispenser will be obtained: <br />e, -c, cz e <br />9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name <br />Address <br />Hauler Registration # Phone c _) <br />City <br />b. If soil is not to be hauled, describe what will be done with it: <br />4 <br />Zip __: <br />
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