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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MADISON
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423
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3500 - Local Oversight Program
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PR0544427
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
5/6/2019 5:20:12 PM
Creation date
5/6/2019 4:54:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544427
PE
3528
FACILITY_ID
FA0004581
FACILITY_NAME
CHASE CHEVROLET*
STREET_NUMBER
423
Direction
N
STREET_NAME
MADISON
STREET_TYPE
ST
City
STOCKTON
Zip
95203
CURRENT_STATUS
02
SITE_LOCATION
423 N MADISON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK)!CONTAMINATION SITE REPORT <br /> �EMERGENCY HAS STATE OFFICE OFEMERGENCYSERVICES FORLOCALAGENCYt3SEONL�f <br /> } <br /> REPORT FILED? k 1:ORL GPFiGENI IiAT I AM A DESIGNATED GOVERNMENT EMPLOY E AN4 THAT t HAVE 1 <br /> YES NO YES [� NO AEPORTEO THIS tNFORMATKA.TO LQCAL OFF1C(Al5 PURSUANT TO'SECTION 251BQ1 OF <br /> C RT DATE <br /> CASE x I THE HEALTH AND SAFT'1t70DE <br /> j1 JAI i <br /> IGNED <br /> OM V M a a o 0v Y SIGNATURE <br /> NAME OF INDIVIDUAL FILING REPORT j PHONE �j <br /> m COM PAW OR AGENCY NAME <br /> O REPRESENTING OWNERIOPERATOR REGIONAL BOARD ---...���-^��� IJ N <br /> `�J,� <br /> K LOCAL AGENCYLu <br /> OTHER IIS <br /> a �I <br /> ADDRESS 7 aOQ / ! , [/']��f] <br /> U� (���/ ,,��f V�ir_•1�J��•'r��� CITY \MI ! I�! STATE •�`� `� I ZIP <br /> ( • "l`' STREET <br /> NAME CON ACQTP`ERSON i IPHONEa <br /> m UNKNOWN I^Q_n CA.+ <br /> Ves�rneA+ Co ❑ <br /> aADDRESS 4 4 Lr, <br /> O - V(o f GITY I � STATE V P <br /> . 1 <br /> STREET <br /> FACILITY NAME(IF APPLICABLE) /1 jf' OPERATOR j PHONE <br /> Pi 1&eo rI 0 Qi Co!Yl <br /> ADDRESS E � � <br /> (spy //� <br /> v J qa 3 `STI4EET ✓'v C,GIINTY �V'�+cz-pp <br /> CROSS STREET TYPE OF AREA �COMMERCIAL �INDUSTRIAL�RURAL TYPE OF BUSINESS � RETAI FUEL STATION <br /> y FARM gj OTHER e5 <br /> !��O N+ 0 RESIDENTIAL 0 OTHER <br /> LOCAL AGENCY i AGENCY NAME COTAC7PERSON I PHONE <br /> w , <br /> w�' r��Oa n� —P 1 S E� I1 <br /> w REGIONAL BOARD II �I'1pIpII{{I1/PHONE ii <br /> J I14 \ } <br /> Q. <br /> (� NAME ! j QUANTITY LOST,(GALLONS) <br /> i <br /> y ii i <br /> �iLK. UNKNOWN <br /> O (2) I I <br /> UNKNOWN <br /> w 1. PPP <br /> r DATE DISCOVERED HOW DISCOVERED INVENTORY CONTROL SUBSURFACE MONITORING NUISANCE CONDITIONS <br /> LLJ <br /> z <br /> O M M .1 4/Dj YL y 0 TANK TEST TANK REMOVAL 0 OTHER ! <br /> DATE DISCHARGE BEGAN I� METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) ;! <br /> >` UNKNOWN REMOVE CONTENTS E::] REPLACE TANK CLOSE TANK <br /> W M M G Q Y Y + # <br /> HAS DISCHARGE BEEN STOPPED? I� REPAIR TANK REPAIR PIPING CHANGE PROCEDURE <br /> o YES R <br /> NO IFYES,DATE OM 5M f p n y y <br /> OTHER <br /> w SOURCE OF DISCHARGE TANKS ONLY/CAPACITY MATERIAL CAUSE(S) <br /> TANK LEAK UNKNOWN Ih� GAL. 0 FIBERGLASS ' a OVERF;LL 14UPTUREIFA{LURE <br /> C3 PIPING LEAK AGE II YRS STEEL ;CORROSION UNKNOWN <br /> OTHER UNKNOWN OTHER �!SPILL OTHER <br /> iy a CHECK ONE ONLY <br /> vUNDETERMINED SOIL ONLY I I�GROUNDWATER E::] DRINKING WATER-.(CHECK ONLY IF WATE WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> , <br /> w y ryLt I CLEANUP IN PROGREr <br /> CC <br /> ESS SIGNED OFF:(CLEANUP COMPLETED OR UNNECESSARY) <br /> v SITE INVESTIGATION IN PROGRESS(DEFINING EXTENT OF PROBLEM) <br /> IM <br /> ONO ACTION TAKEN POST CLEANUP MONITORING IN PROGRESS NO FUNDS AVAILABLE TO PROCEED I!4 EVALUATING CLEANUP ALTERNATIVES <br /> CHECK APPROPRIATE ACTIONS)(SEE BACK FOR DETAILS) <br /> 11 I I! <br /> z CAP SITE(CO) EXCAVATE&DISPOSE(ED) REMOVE FREE PRODUCT(FP) ENHANCED BIO DEGRADATION(IT) <br /> O O IM <br /> Lu <br /> 0 CONTAINMENT BARRIER(CB) 0 EXCAVATE&TREAT(ET) PUMP&TREAT GROUNDWATER(G f) REPLACE SUPPLY(RS) <br /> I <br /> TREATMENT AT HOOKUP(HU) NO ACTION REOUIRED(NA) OTHER(OT) <br /> du <br /> U co rxsA.- — <br /> ' per a., �1 -� cin <br /> (J/ 7 <br />
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