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REMOVAL_1998
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PR0508038
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REMOVAL_1998
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Last modified
4/1/2020 11:52:51 AM
Creation date
11/2/2018 4:57:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
1998
RECORD_ID
PR0508038
PE
2381
FACILITY_ID
FA0007904
FACILITY_NAME
HENRY HANSEN PROPERTY
STREET_NUMBER
200
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
200 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
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\MIGRATIONS\C\CHEROKEE\200\PR0508038\REMOVAL 1998.PDF
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EHD - Public
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11. GENERAL INFORMATION: <br />I. Obtain an EPA Site Number from the Department of Toxic Substances Control (900) 61 -TOXIC for <br />temporary hazardous waste removal activities associated with underground storage tank {UST) removals. <br />2. Disposal Information: Public health Services Underground Storage Tank Disposition Tracking Record <br />(UST Tracking Record, page 10) shall accompany each tank removed from site. Tank(s) will be issued <br />an Identification number which PHS-EHD's representative will note on the UST Tracking Record. <br />Contractor will affix same identification number onto tank end using fluorescent spray paint. Contaminated <br />tanks and/or piping are to be transported under Hazardous Waste Manifest by a state registered hazardous <br />waste hauler. <br />3. Contractor to Provide: Combustible/Flammable gas detector (lo verify the Lower Explosive Limit (LEL) <br />atmosphere and oxygen level of tank prior to lifting from excavation), adequate number(s) and appropriate <br />type(s) of fire extinguisher(s), barriers to secure the area as necessary to minimize traffic and pedestrian <br />interference, and fluorescent spray paint to affix tank identification numbers. It shall be the project <br />manager's responsibility for compliance with all health & safety regulations and requirements, which shall <br />be strictly adhered to at all times during the course of the closure activities. <br />4 The PHS-EHD permit shall be on site during tank excavation and removal. <br />5. Any changes in this document shall be approved by PHS-EHD prior to initiating work. <br />6. Closure -in -Place: If Closure -in -Place is the suggested method of abandonment, complete form <br />EH 23 039 and submit written approval from the local Fire Department. <br />7. Temporary Closure: If Temporary Closure is the suggested method of abandonment, complete <br />and submit this form and a written approval from the local Fire Department. <br />e. The following documentation shall be submitted within 30 days of the tank removal <br />(late: <br />a) Analytical results, mailed directly from laboratory to PHS-EIID, including a chain of custody and <br />quality assurance and quality control (QA & QC). <br />b) UST Tracking Record Sheet(s) and/or Tank Hazardous Waste Manifest(s). <br />c) Hazardous Waste Manifests for piping, rinsate, residual fuel, or waste oil receipt. <br />d) Submit the backfill excavation certificate as required by San Joaquin County and the incorporated <br />City Building Departments. This report will be referred to the appropriate agency for their <br />review. <br />A site which has had UST(s) removed, shall not be considered for final closure until the above Items <br />are submitted for review. <br />III. SITE MITIGATION: <br />1. In the event contamination is observed, confirmed or suspected as a result of a leaking UST system it is <br />the responsibility of the owner or operator to submit a workplan to PHS-EHD Site Mitigation Unit prior <br />to initiating any assessment or remediation activities. To minimize delays, a Corrective Action Plan may <br />be submitted concurrent with tank closure or installation plans. Address one copy of the Corrective Action <br />Plan to the Site Mitigation Unit for review. For finther assistance contact the Site Mitigation Unit at (209) <br />469-3450. <br />EH 23 046 (Revised 9/11/96) Page 2 <br />
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