My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
UAR/PROP 65_PRE 2019
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CALIFORNIA
>
2315
>
2300 - Underground Storage Tank Program
>
PR0231032
>
UAR/PROP 65_PRE 2019
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
4/1/2020 11:52:59 AM
Creation date
11/2/2018 3:52:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
UAR/PROP 65
FileName_PostFix
PRE 2019
RECORD_ID
PR0231032
PE
2381
FACILITY_ID
FA0004062
FACILITY_NAME
VOGUE CLEANERS
STREET_NUMBER
2315
Direction
N
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95204
APN
12538016
CURRENT_STATUS
02
SITE_LOCATION
2315 N CALIFORNIA ST
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\CALIFORNIA\2315\PR0231032\UAR_PROP 65.PDF
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
5
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
_ 9 _ vim <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FOR LOCAL'AGENCY USE ONLY <br /> ❑ YES NO REPORT BEEN FILED? E] YES ❑ IHEREBYCERTIFYTHATI.HAVE DISTRIBUTED THIS INFORMATION ACCORDING TO THE <br /> DISTRIBUTION SHOWN ON THE INSTRUCTION SHEET ON THE BACK PAGE OF THIS FORM <br /> REPORT(pMTE/ 6Y CASES .SIGNED SATE . <br /> NAME OF INDIVIDUAL FILING REPORT PHONESIGNATURE <br /> S ) 'fb��Y6 ' <br /> M REPR ENTING ❑ OWNERK)PERA R ❑ REGIONALBOARD COMPANY OR AGENCY NAME <br /> SDg.LOCAL AGENCY ❑ OTHER <br /> a ADDRESS ��' ••• <br /> Ci9 ATE 9sao <br /> w Np <br /> NAME CONTACT PERSON PHONE <br /> M11m iw Qi UNKNOWN 06 <br /> U❑ <br /> ADDRESS <br /> P. o. gax 3!0 G� 4sa�7 <br /> STREET CRY STATE IP <br /> FA IL NAME(IF APPLICABLE) OPERATOR PHONE <br /> ADDRESS <br /> s c.- s,CITY NTY qua <br /> yCROSS STREET <br /> i LOCALAGENCY AGENCY NAME CONT R e PHONE <br /> w saw "e E td o� X68 3 b <br /> w a REGIONAL BOARD u PHONE <br /> as <br /> w (1) NAME OUANTITY LOST(GALLONS) <br /> �XIO <br /> a UNKNOWN <br /> m <br /> UNKNOWN <br /> Z DATE DISCOVERED —/,I <br /> �/J 9 HOW DISCOVERED ❑ INVENTORY CONTROL ❑ SUBSURFACE MONITORING ❑ NUISANCE CONDITIONS <br /> o i Y Y ❑ TANK LEST TANK REMOVAL ❑ OTHER <br /> METHOD USED TO STOP <br /> R (CHECK ALL THAT <br /> m DATE DISCHARGE BEGAN UNKNOWN w Yl RE MOVE CONTENTS ISCHACLOSE TANKS REMOVE PPLID❑REPAIR PIPING <br /> p HAS DISCHARGE BEEN STOPPED? `1',16, <br /> ❑REPAIR TANK ❑CLOSE TANK A FILL IN PLACE ❑CHANGE PROCEDURE <br /> 1-1 <br /> p YES ❑ NO IF YES,DATE OM 6 DD •7 [D REPLACE TANK ❑ OTHER <br /> V DISCHARGE CAUSES) <br /> as TANK LEAK ❑ UNKNOWN ❑ OVERFILL ❑ RUPTURE/FAILURE ❑ SPILL <br /> �U ❑ PIPING LEAK ❑ OTHER CORROSION ❑ UNKNOWN ❑ OTHER " <br /> ww CRECKONEONLY <br /> O UNDETERMINED ❑ SOIL ONLY ❑ GROUNDWATER ❑ DRINKING WATER -(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK <br /> ///ONE ONLY <br /> wZ Iyl NO ACTION TAKEN ❑ PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED ❑ POLLUTION CHARACTERIZATION �1 <br /> jy LEAK BEING CONFIRMED ❑ PRELIMINARYSITE ASSESSMENT UNDERWAY ❑ POST CLEANUP MONITORING IN PROGRESS _ <br /> U ❑ REMEDIATION PLAN ❑ CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION(S) ❑ EXCAVATE&DISPOSE(ED) ❑ REMOVE FREE PRODUCT(FP) ❑ ENHANCEDBIOOEGRADATION(IT) <br /> J IYEe,EFfUR�El.V81 <br /> a p ❑ CAP SITE(CD) ❑ EXCAVATE&TREAT(ET) ❑ PUMP&TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY(RS) <br /> wr <br /> as ❑ CONTAINMENT BARRIER(CB) ❑ NO ACTION REOUIRED(NA) ❑+ TREATMEy/(aNy.T�ATHOOKUP(HU) E::] VENTSOIL(VS) <br /> ❑ VACUUM EXTRACT(VE) OTHER(OT) asgogs // , <br /> + <br /> N9C65IMP& <br />
The URL can be used to link to this page
Your browser does not support the video tag.