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ARCHIVED REPORTS XR0000267
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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6437
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2900 - Site Mitigation Program
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PR0526345
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ARCHIVED REPORTS XR0000267
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Last modified
2/5/2019 4:26:05 PM
Creation date
2/5/2019 3:54:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000267
RECORD_ID
PR0526345
PE
2957
FACILITY_ID
FA0017827
FACILITY_NAME
FLAG CITY SHELL
STREET_NUMBER
6437
Direction
W
STREET_NAME
BANNER
STREET_TYPE
ST
City
LODI
Zip
95242
APN
05532019
CURRENT_STATUS
01
SITE_LOCATION
6437 W BANNER ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD <br /> CENTRAL VALLEY REGION <br /> ORDER NO R5-2003-0044 <br /> ATTACHMENT A <br /> TO <br /> GENERAL ORDER FOR LAND DISPOSAL <br /> OF GROUNDWATER AND SURFACE WATER FROM CLEANUP OF <br /> PETROLEUM FUEL POLLUTION <br /> APPLICATION REQUIREMENTS <br /> A Report of Waste Discharge (Form 200 plus supplemental information) and filing fee must <br /> be submitted to the Regional Water Quality Control Board, Central Valley Region (Regional <br /> Board) for each proposed discharge The Report of Waste Discharge shall be prepared by or <br /> under the direction of a California Registered Civil Engineer, Registered Geologist, or <br /> Certified Engineering Geologist and shall provide at least the following information or, if a <br /> Problem Assessment Report (or functional equivalent) has been approved, it may be <br /> submitted Additional data may be requested for specific sates <br /> A. Wastewater treatment system and characteristics <br /> 1 Description of event(s), which caused the waste to be discharged to <br /> groundwater pollution, including type and source of the waste constituents and <br /> date(s) when the discharge occurred and was discovered <br /> 2 Narrative and schematic descriptions of the proposed extraction, treatment, and <br /> disposal systems The designated disposal area must be shown on a map with an <br /> accuracy of plus or minus two feet If the proposed treatment system uses <br /> activated carbon, submit an estimate of the breakthrough time for each carbon <br /> treatment unit <br /> 3 Any water supply well, and surface waters, within 0 5 males of the site shall be <br /> identified on a map <br /> 4 A map showing the location of the facility, plume, extraction well(s), <br /> monitoring wells, treatment system, disposal facilities and site boundaries <br /> 5 The anticipated average and maximum flows from the treatment system <br /> b An operation plan describing general operations and maintenance procedures, <br /> process controls, monitoring and pumping rates <br /> 7 Representative data for the following analyses of the groundwater that will be <br /> treated and discharged (note required quantitation (or reporting) limits are <br /> • found in Part C 1 of this Order) <br />
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