Laserfiche WebLink
UNDERGROUND STORAGE TANKUNAUp10RCZED PEL A$E(L,EM tCONT IWAT►0 <br /> EMEROENCy _.N, lEPORT <br /> y $ <br /> HAS STATE OFFK OF€M ENCY <br /> €I,�a S.RVIBE8 <br /> Q � f�EPORT BEEN F{,Ep'{ 11, <br /> ; <br /> ?p} _ �y�� y4A� <br /> REPORT DATE _ 7& - _ "'•`!l"' �:,. �: <br /> S. <br /> AME OF WDIVOUpLF RT - T ' •-%idyv ..:c; r � <br /> ' <br /> REPRESENTING TJWNEROPEMTOR Q flEOIONAI BOARCI COMPANYOR AGENCYNAME <br /> q LOCAL AGENCY,' -OTHER <br /> !gh ADDRESS <br /> m� � �� .. - CONTACTPEASON PHONE :.t�L'LD <br /> Q LrBODwN <br /> y ADDRESS <br /> &too <br /> 6 REA <br /> ACLm NAME(FAPPLIDABLE)S OPERATOR P�rJ�� <br /> fl yI� <br /> IUD ' <br /> qROf <br /> S STREET <br /> • TYPE OF ARETE!DOTNER_ <br /> MERCNL Q WWSTRLLL Q RURAL TYPE OF BUSWESS Q RETAILFUEL�STA,TION <br /> AGENA;mCV�EroENTIAL Q FMM'�'OTHEJC.Y� <br /> biai <br /> LOCAL AGENCY ���NNNJT7ACIPEn N <br /> P�H/fON�E <br /> REGIONAL BO RD W I <br /> etl� _ IPHONE1 <br /> 111 1 NAME <br /> P fly QUANTITY LOST(GALWNS) <br /> P75755`j`j 54 L•VT� V UE, UNKNOWN <br /> t DATE DISCOVERED HOW DISCOVERED Q <br /> WyENTOM CONTfgL <br /> Gi //�� Q SUBSURFACE MONITORWG Q NULSANCEOOADRONS <br /> w V u ' o o $Yl Q TAM(TEST � TANKREMOVAL Q OTHER <br /> DATE <br /> DISCHARGE BEGAN METHODUSEDTOSTOP DISGUROE <br /> (CF <br /> meq/' IECK ALLTiNTAPPLY) <br /> M u D Y 1 A -Y :. .C7DWN Q REMOVECONTENTS Q REPLACE TAN( OLOSE TAN( <br /> )IAS DISCHARGE BEEN STOPPED? _ Q REPAIR TANK REPAIR PIPING Q CHANGE PROCEDURE <br /> O YES Q NO FYES,DATE - Q OTHER <br /> D Y <br /> yy <br /> SOURCE OFDI <br /> RC# TMIKS ONLV.CMA()ITY MATERIAL CAUSE(S)TANKKLEAKLEAK UNODWN _ DAL, Q FIBERGLASS Q OVERFILL Q RUPTUREFALURE <br /> Q PIPINGLEAK AGE YRS STEEL Q CORROSION Q UNKNOWN <br /> Q OTHER TP5UN<NOWN Q OTHER <br /> ywy Q SPILL OTHER <br /> CHECK ONE ONLY <br /> t3Z Q UNDETERMINED SOIL ONLY Q GROUNDWATER Q DRINKING WATER (CHECK ONLY F WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> F <br /> CHECK ONE ONLY <br /> SITE INVESTIGATION IN PROGRESS(DEFINING EXTENT OF PROBLEM) Q CLEANUP IN PROGRESS Q SIGNEDOFF nEANUP COMPLETEDOR UNNECESSARY) <br /> t�w Q NOACTIONTAKEN Q POST CLEANUP MONITORING W PROGRESS Q NOFUNDSAVALABLE TO PROCEED Q EVALUATWOCLEANUPALTERNATNES <br /> CHECK APPROPRIATE ACTION(S)(SEE BACK FOR DETAILS) <br /> Q CAP SITE(CD) Q EXCAVATE&DISPOSE(F-D) Q REMOVE FREE PRODUCT(FP) Q ENHANCED BO DEGRADATION(IT) <br /> Q CONTAINMENT BARRIER(CS) Q EXCAVATE&TREAT(ET) PUMP&TREAT GROUNDWATER <br /> Q (Gn Q REPLwcE SUFPLv(RS) <br /> Q TREATMENT AT HOOKUP O*Q Q NOACTK)NREOUIRED(" Q OTHER(On <br /> v <br /> Iw "I"A <br />