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--LLI D to <br /> UNDERGROUND STORAGE TAN'rftAUTHORIZED RELEASE (LEAK)'MONTAIIIIINATION SITE REPORT <br /> .. ........ <br /> EMERGENCY HSTATE OFFICE OF EMERGENCY SERVICES F'ti35CAL.At kitSYtlSL2>wE:Y <br /> S <br /> PEPORTBEEN FILED? 1HLlE�1k� Fi'IfFYhUITIAiMKL7ESItlNA'f133xk7 'FkAEl13' lr�L.l71" :A 1 <br /> YES ® NO 0)Es O N) ftAVE#1�Pf1F1'4E+ $ L 'iix�il:'}IbhTP(S�';: o 'r <br /> 2518730t `k1AANt3SA[' '!`f M"�sE"�"` <br /> REPORT DATE(MM-DD-YY) CASE# s. <br /> O6a `fi.E»xr. <br /> 05/14/91 <br /> 17019 <br /> :,,;;<;:s*;<'.;:::?:,,,;.;::;�:;.;:>::a:'::<�;:.::;>,;•. <br /> NAME OF INDIVIDUAL FILING REPORT PHONE SIGN RE <br /> > Elaine Lavine (415)-571-2482 <br /> o REPRESENTING [ O6ANEF10PERATOR OFIEGICNALBOARO COMPANY OR AGENCY NAME <br /> Ov0(.PLAGENCY OOTHEq ARCO Products Company <br /> O <br /> ADDRESS P.O.Box 5811 San Mateo CA 94402 <br /> STREET CITY STATE aP <br /> NAME CONTACT PERSON PHONE <br /> Fn ARCO Products Company OUNKNowN Elaine J.Lavine (415)-571-2482 <br /> O ADDRESS San Mateo CA 94402 <br /> PO BOX 5811 ATTN: Env.Compl.Dept. Gln STATE aP <br /> STREET <br /> FACILITY NAME OF APPUCABLE) OPERATOR PHONE <br /> o ARCO FACILITY 00760 DAVID HILDENBRAND (209)-368-7863 <br /> U ADDRESS 225 S CHEROKEE LODI SAN JOAQUIN 95240 <br /> w <br /> STREET CITY COUNTY aP <br /> "- CROSS STREET <br /> y LODI AVE/S CHEROKEE <br /> Iwmn LOCALAGENCY AGENCY NAME CONTACT PERSON PHONE <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH DOUG WILSON (209)-468-3420 <br /> REGIONAL BOARD PHONE <br /> CENTRAL VALLEY REGION LEEBOGGS (916)-361-5600NAME OUWnTY LOST(GALLONS) <br /> GASOLINE UNKNOWN <br /> (� OLWATITY LOST(GALLONS) <br /> = 0 UNKNOWN <br /> N <br /> DATE DISCOVERED(MM-DD-YY) HOWDISCOVERED ONVENTORYCONTROL OSUBSURFACEMONITORING [—]NUISANCE CONDITIONS <br /> QZ 05/10/1991 TANK TEST OTANCREMOVAL ®OTHER GAS DELIVERY <br /> DATE DISCHARGE BEGAN(MM-DO-YY) METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> O i� 05/10/1991 QUNKNOWN ❑REMOVE CONTENTS Q REPLACE TANK QCLOSE TANK <br /> HAS DISCHARGE BEEN STOPPED 7 O REPAIR TANK O REPAIR PIPING OCHANGE PROCEDURE <br /> 0 YES ONO IF YES,DATE 05/10/1991 Q OTHER CHECK OUT OPW 61 VALVE <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> jjOTAAKLEAK O UNKNOWN O OVERFILL RUPTUREIFAILURE M SPILL8 V OPPNG LEAK OX OTHER O CORROSION O UNKNOWN O OTHER <br /> W w CHECK ONE ONLY <br /> ®UNDETERMINED OSOL ONLY OGROUNDWATER ODFWdNGWATEA-(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> O NO ACTION TAKEN O PPEUMNARY SITE ASSESSMENT WORKPLAN SUBMITTED O POLLUTION CHARACTERIZATION <br /> ip U y O LEAKBEING CONFIRMED O PRELIMINARY SITE ASSESSMENT UNDERWAY O POSTCLEANUP MONITORING IN PROGRESS <br /> O REMEDIATION PLAN 0 CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) O CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTIONS) O EVACUATE AND DISPOSE(ED) O REMOVE FREE PRODUCT(FP) OENHANCED BIO DEGRADATION Pn ' <br /> w FO CAP SITE(CO) O EVACUATE AND TREAT(ET) O PIMA&TREAT GROUNDWATER(GT) O REPLACE SUPPLY(RS) <br /> 20 O CONTAINMENT BARRIER(Ce) OX NOAC11ON REQUIRED(NA) O TREATMENTAT HOOKUP(HU) OVENTSUPPLY(VS) <br /> O VACUUM EXTRACT(VE) 0 OTHER(OT) <br /> P DURING TANK FILL GAS BACKED UP OUT OF VENT PIPES. FIRE DEPARTMENT CLEANED UP SPILL G <br /> CONTRACTOR VERIFIED PIPES IN WORKING ORDER. SAN JOAQUIN COUNTY AND OES NOTIFIED. <br /> 0 G <br /> 0 <br /> 0 <br />