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ARCO Products Companya� Report of Spillage/Product Loss <br /> Division of AtlantleRknf pony <br /> Retail Marketing <br /> Date of incident Tlme of incident Date of report <br /> Address(street,city,state) Facility number Region <br /> t'a-- Lod : C� er �CD S. <br /> T. Description of incident II <br /> CO FN }R ^c'1O2 Qb1 � � f AKk LING f ¢ St Det NP-7L' il�N <br /> L P.�A. K- c.-�-eGP�, v <br /> �� a -s 5 `^ ^- P LA 2 <br /> 2.Corrective action taken(Including spill containment and clean-up all <br /> p S P L 4— i4 .✓ 42 K Lsti 2 P r <br /> tiA-, SA- <br /> o <br /> 3. Did spill r n public waterway <br /> _ yes rNo Describe in all cases <br /> N.Wa;spill confined to Company property If 'no;'submit ARC-0-77 <br /> 4.A <br /> s = No Describe in NI cases <br /> gn MAY" a QUANTITY LOST(GALLONS) <br /> 3 G,g D L UNKNOWN <br /> Oil <br /> ❑ UNKNOWN <br /> i DST"DiREDHDW DIa )VTiRED ❑ WVENTORYOCNTRpL ❑ SUBSURFACE MONITORING ❑ NUISANCECONDITIONs <br /> DAN r/r 4 e 9. l TAN(TEST ❑ TAN(REMOVAL ❑ OT1ER <br /> DATE DISCHARGE BEGAN QM METHOD USED TO STOP DISONWRDE(HECK ALL THAT APPLY) <br /> 1�y K�iH �r b /. ❑ LoseloWN ❑ mum KAN18Re ❑ I eum TANK ❑ cLoe"TANK <br /> 1T HAS DLM>VJ >E BEEN STOPPED?b8 // ❑ REPHEAIR TAW AWAR PIPING /❑ CHANGE PR0�1yRE j YES ❑ NO FYES.OATEv 40 /i <br /> 7.4 /��J / r, OTR ^— Gh� L«/C 4/G <br /> SOURCE OF DISCHARGE cAwaiiial <br /> 3 ❑ TA+KKE.M(M ❑ LOW40 N ❑ OVEFFI L ❑ RLPRM-*ALISE ❑ SPILL <br /> �1Ryp ❑ <br /> PPM LEAK 0T1ER ❑ CORMs10N ❑ WKOWM pTHER CCA IC <br /> CHECK ONE CALY <br /> O F ❑ UIOETERYIMED ❑ BOIL ONLY ❑ GRCNOWATER ❑ DRINKING WATER- 04ECK ONLY F WATER WELLS HAVE ACTUALLY BEEN AFFECTEOI <br /> HRECK ONE ONLY <br /> ❑ ND ACTION TAKEN ❑ PRELNWAwfsm AnLuwNTwoRIfPIANSUBYfTTED ❑ POLLUTIONHAMOTERIZATON <br /> w ❑ LEAK BEWOCDWIRYED ❑ PRELMNWRYSMASSEMBYENTLNMRWAY ❑ POST OLFA/aP MONITORING N PROGRESS <br /> ❑ REMEDUTICN PLµ CASE CLOED IHFANIP CONPIFTED OR UNNECESSARY) ❑ C.EANIIP UNDERWAY <br /> HECK APPROPRIATE ACTON(s) OICAVATE a owS om(EDI <br /> a•..m,+a ❑ ❑ REMOVE FREE PRDCUCT(Flit ❑ ENHANCED BD DEGRADATION Im <br /> ❑ CAP SITE R:bl ❑ EXCAVATE A TREAT(ET) ❑ "LW A TREAT GROUNDWATER((IT) ❑ REPLACE SUPPLY(AS) <br /> ❑ CONTAWYENTBARRER(l9) ---4�!j ACTON REQUIRED INA) TREATYENTATIOOgPW ❑ VEAL SOIL(M <br /> ❑ VACUUM ERMCT(VE) ❑ OTHER ROT) <br /> n 20 !- YL p_ 3 yS•G .�o/Y�.A.AV - e.,, W; s o - 7- Z� -91 3:7J.rO y7. <br /> V d G S ,�%�.G.r9- NQ e-P a,.,7 / 8/7 S - %•-.R.� K e.e G 1 � zL '�1i <br /> 8�e - 8SZ-7 Sib <br /> nFsn�Aw <br />