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UAR/PROP 65_PRE 2019
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PR0501198
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UAR/PROP 65_PRE 2019
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Entry Properties
Last modified
1/13/2021 8:48:56 AM
Creation date
11/5/2018 10:06:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
UAR/PROP 65
FileName_PostFix
PRE 2019
RECORD_ID
PR0501198
PE
2381
FACILITY_ID
FA0005019
FACILITY_NAME
BANNER ISLAND BALLPARK
STREET_NUMBER
404
Direction
W
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13741017
CURRENT_STATUS
02
SITE_LOCATION
404 W FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\F\FREMONT\404\PR0501198\UAR_PROP 65.PDF
Tags
EHD - Public
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UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK) /CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVIEff�F <br /> I ILOCALATGIENCY USE ONLY <br /> H EBY CER� <br /> YES DKrNO REPORT BEEN FILED 7 EJOBY CER FY T I AM A ESIrNATED GOVERNMENT EMPLOYEE AND THAT I HAVE <br /> 0 YES Ej P ' NI MATION 0 LOCAL OFFICIALS PURSUANT CTION 25180.7 OF <br /> "IS <br /> D <br /> ED <br /> T' <br /> REPORTIDATE CASE# THE�HTI'AND S' <br /> '�-I SIG-NED J� DATE <br /> 9 1 <br /> NIME�INUIVIUUAL FILI PORT PHONE SIG TURE. <br /> In r-, M . TIN <br /> REPRESENTING <br /> 0 OWNERIOPERATDR F--j REGIONALBOARD COMPANY OR AGENCY NAME <br /> 'LOCAL AGENCY OTHER_ <br /> ADDRESS le,"4�j v, VeAll <br /> U6 — �eu Al Siti3 uu�� mXA 06ZI <br /> NAME CONTACTPERSON PHONE <br /> a%Ttv- UNKNOWN <br /> ADDRESS M0444bi4v- <br /> Fo <br /> �131 c"5AC(44P� c4A-, <br /> FACILITY NAME(IF APPLICABLE) <br /> r OPERATOR PHONE <br /> C g��-qtu <br /> ADDRESS <br /> -4c4 <br /> GROSS STREET <br /> Vft)3 1�auj�j <br /> LOCALAG ArENCY NAME. �TACTPERSON <br /> PHONE <br /> U i�L( <br /> PHONE <br /> ..�GIONALBOARD <br /> A <br /> NAME QUANTITY LOST(GALLONS) <br /> ------,NrUNKNOWN <br /> L:j UNKNOM <br /> DATE DISCOVERED HOWDISCOVERED <br /> E:] INVENTORY CONTROL Ej SUMRFACEMONITOR04G NuisANcrOONDITONS <br /> (.0yl E:l TANK TEST TA REMOVAL E] OTHER <br /> DATE DISC14ARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY-) <br /> Ml MI 01 DI Yl Yl >6JINKNOWN REMOVECONTENTS REPLACETANK 5eCUOSE TANK <br /> HAS DISCHARGE BEEN STOPPED 7 REPAIRTANK REPAIR PIPING CHANGE PROCEDURE <br /> ;S�YES [-] NO IFYES,DATE OTHER <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> [D TANK LEM F�WrUNKNOVVN OVERFILL RUPTURE(FAILURE SPILL <br /> [::] PIPINGLEAK F-1 OTHER CORROSION UNKNOWN OTHER_ <br /> w CHECKONEONLY <br /> 0 UNDETERMINED SOILONLY D<GROUNDWATER E] DRINKINGWATER (CHECK ONLY F WATER WELLS HAVEACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> F'� NO ACTION TAKEN PRELIM WARY SITE ASSESSMENT WORKPLAN suam IT RED E::] POLLu-noNcHARAcTEFuzATioN <br /> LEAK REINS CONFIRMED PRELIMINARY SITE ASSESSMENT UNDERWAY <br /> Ej POST CLEANUP MONITORWG IN PROGRESS <br /> F-1 REMEDIATIONPLAN F-] CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) [�:] CLEANUP UNDERWAY <br /> z CHECK APPROPRIATE ACTION(S) EXCAVATE&DISPOSE(ED) REMOVE FREE PRODUCT(FP) ENHANCED BIODEGRADATION(IT) <br /> (-W7 <br /> F� CAPSITE(CD) EXCAVATE&TREAT(ET) ED PUMP&TREAT GROUNDWATER(GT) REPLACE SUPPLY(RS) <br /> CONTAINMENT BARRIER(OR) NO ACTION REQUIRED INA) TREATMENTAT HOOKUP(HUI VENTSOIL(VS) <br /> F-1 VACUUM EXTRACT(M E:] OTHER(OT)_ <br /> r st Uk_et�, LQQc� (j��j 62-c. <br /> z ;HT Pvc�wk lofioho- <br /> w <br />
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