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COMPLIANCE INFO 2001-2006
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PR0516736
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COMPLIANCE INFO 2001-2006
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Last modified
4/1/2020 11:52:22 AM
Creation date
11/8/2018 9:48:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2006
RECORD_ID
PR0516736
PE
2361
FACILITY_ID
FA0012764
FACILITY_NAME
SAFEWAY FUEL CENTER #1769
STREET_NUMBER
2802
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2802 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\C\COUNTRY CLUB\2802\PR0516736\COMPLIANCE INFO 2001-2006.PDF
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EHD - Public
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4 <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE LEAK /CONTAMINATION SITE REPORT <br /> EMERGENCY DES REPORT FILED L UE$�6CY <br /> YES El NO [ YES El NO <br /> REPORT DATE CASE r`c ' FfilSpDf4r& <br /> 01 91 01 61 01 51 05-5178111i,'+e\r3:. <br /> M M D 0 Y Y A::ei!x.,Ya"a�4�J:•.:•.^.ac.>n':c::a:ua::a:i::a:. m.:3.9�:a._:y:: <br /> NAME OF INDIVIDUAL FILLING REPORT <br /> Ian A. Ellis 336-315-2837 <br /> REPRESENTING I COMPANY OR AGENCY NAME <br /> REPORTED O LOCAL AGENCY O REGIONAL BOARD <br /> BY ED CWNER PERI OTHER Gllbarco Veeder Boot <br /> ADDRESS <br /> 7300 W.Friendly Ave Greensboro NC 27420-2087 <br /> STREET CITY ST ZIP <br /> NAME CONTACT PERSON <br /> Safeway, Inc. James Schwartz 925-469-7306 <br /> RESPONSIBLE <br /> PARK ADDRESS <br /> P.O.Box 9070 Pleasanton CA 94588-3229 <br /> STREET CITY ST ZIP <br /> FACILITY NAME OPERATOR PHONE <br /> 1769 Safeway-Nor Cal Sharon Louveture 209-461-5555 <br /> SITE <br /> LOCATION 2808 Country Club Blvd Stockton CA 95204 <br /> ADDRESS CITY ST ZIP <br /> CROSS STREET <br /> LOCAL AGENCY AGENCY NAME CONTACT PERSONPHONE <br /> AGENCIES County of San Joaquin CUPA Doug Wilson 209-468-3446 <br /> PHONE <br /> OES Chris Flure 800-852-7550 <br /> 1 NAME QUANTITY LOST(GAL LONSI <br /> Gasoline <br /> SUBSTANCE 3 gallons El <br /> INVOLVED 2 QUANTITY LOST(GALLONS) <br /> 11 UNKNOWN <br /> 0 9 0 6 0 5 TANK TEST TANK REMOVAL NUISANCECONDITK)NS E] <br /> M M D D Y Y INVENTORYCONTROL SUBSURFACE MONITORING Seen Visually OTHER X❑ <br /> METHOD USED TO STOP DISCHARGE <br /> DATE DISCHARGE BEGAN UNKNOWN O REMOVE CONTENTS CLOSE TANK&FILL IN PLACE 0 <br /> WCOVERY Q 91 0 6 g 5 REPAIR TANK REPAIR PIPING Ej <br /> HAS DISCHARGE BEEN STOPPED X YES NO <br /> 8 �REPLACE TANK CHANGE PROCEDURE 0 <br /> ABATEMENT 0 9 0 6 0 5 CLOSURE TANK&REMOVAL Dispensing disabled OTHER® <br /> SOURCE OF DISCHARGE CAUSE($) <br /> TANK TEST UNKNOWN O OVERFILL UNKNOWN <br /> O PIPING LEAK OTHER ❑% CORROSION SPILL <br /> Dispenser �REPTURE/FAILURE Customer error OTHER ❑X <br /> CHECKONE ONLY <br /> CASE TYPE aX OTHER Concrete SOIL ONLY GROUNDWATER DRINKING WATER(WELLS AFFECTED) <br /> CHECK ONE ONLY <br /> CURRENT NO ACTION TAKEN Q PRELIMINARYSITEASSESSMENTSUBMITTED POLLUTION CHARACTERIZATION <br /> STATUS LEAK BEING CONFIRMED O PRELIMINARY SITE ASSESSMENT UNDERWAY POST CLEANUP MONITORING IN PROGRESS <br /> O REMEDIATION PLAN ®CASE CLOSED(COMPLETED/UNNECESSARY) CLEANUP UNDERWAY <br /> CHECKAPPROPRIATE ACTION(S) <br /> =CAP SITE(Co) EXCAVATE&DISPOSQED) REMOVE FREE PRODUCT(FP) El <br /> REMEDIAL O CONTAINMENT BARRIER(OB) O EXCAVATE&TREAT(ET) PUMP&TREAT GROUNDWATER(GT) O <br /> ACTON Q VACUUM EXTRACT(VET Q NO ACTION REQUIRED(NA) TREATMENT AT HOOKUP(HU) <br /> VENT SOIL(VS) ❑OTHER ENHANCED BIO DEGRADATION(IT) <br /> Customer error on pumpRt caused gasoline to reach concrete pavement. <br /> Station used absorbent material to clean the spill. <br /> COMMENTS Safeway has responded to this issue and all necessary action has been taken. <br /> No further actions are currently planned. <br /> I 9/iw2 <br /> 1'.15 PM <br />
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