My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
P
>
PACIFIC
>
6425
>
2900 - Site Mitigation Program
>
PR0519189
>
SITE INFORMATION AND CORRESPONDENCE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/21/2019 2:38:17 PM
Creation date
8/21/2019 1:52:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0519189
PE
2950
FACILITY_ID
FA0014347
FACILITY_NAME
CURRENTLY VACANT
STREET_NUMBER
6425
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741031
CURRENT_STATUS
02
SITE_LOCATION
6425 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
Jump to thumbnail
< previous set
next set >
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
508
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)!CONTAMINATION SITE REPORT <br /> N EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FOH'L ALAGENCY USE ONLY <br /> REPORTBEENFILEOI <br /> Q <br /> YES NO ONES Q NO flVE <br /> EEpE :CERTIFY <br /> INFORM(AM AAELoc ICIAW,FURSUANT 70 SECTK)N.25780.7ADF <br /> REPORTIDATE' ,V^/7 -CASE# THE HEAL SAF(Y ;� <br />(• M I N D Q/r C/r I SIDNED WTE i <br /> AME O11F^^I{r�DIVID AL FILING REPORT PH NE SIGN Tl1RE. <br />� • Y� . uS61•l ( 1 �- <br /> y <br /> REPRESENTING O OWNERWERATOR O. REGIONALBOARD COMPANY OR AGENCY NAME - <br /> LOCALAGENCY ❑ OTHER KA 61ml ilk) Lo <br /> ADDRESS <br /> STREET STATE <br /> AME CONTACT PERSON p p�/E_ L^/� <br /> UNKNOWN <br /> n ADDRESS <br /> i= 9TREEf {TI/ Crt gfATE (�J �.(jbl <br /> FACT ITY NAME(IF AP'FUCCAABL�E)) _ OPERATORPHONE <br /> a ADDRESS <br /> �{�' <br /> yROSS STREET TYPE OF AREA COMMERCIAL Q'INDUS TRWL O RURAL TYPEOFSUSINESS TAIL FUEL STATION ' <br /> PRESIDENTIAL O OTHER O FARM O OTHER <br /> (� AL AGE CVNCY NAME NTACT PER <br /> y , 1 PHONE 1 <br /> i �N <br /> ww GIONAL BOARD <br /> 9 Yvm-utq per, <br /> —M1�l.(G�V , I L vvv,YST 1 PHONE r <br /> w 19 NAME VVV....../// QUANTITY LOST(GALLONS) <br /> UNKNOWN <br /> 14 - <br /> - UNKNOWN {i <br /> i DATE ISCOVER/E//p_ lgWDISCOVERED I] INVENTORY CONTROL O SUBSURF EMONITORINO O m,ISANCE CONDRpNS j <br /> M M v6 o v v ❑ TANK TEST TANK REMOVAL OTHER 119v1nCo <br /> DATE DISCHARGE BEGAN - - - - METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> w M u- DI 01 v v UNKNOWN - Q REMOVECONTENTS 'REPLACE TANK CLOSETANK <br /> 4 HAS DISCHARGE BEEN STOPPED 7 [j- REPAIRTANK REPAIR PIPING O CHANGEPROCEDURE J <br /> M Q Q ((QQ, <br /> 5 VES Q NO IF YES,DATE � M O OTHER <br /> f' h SOURCE OF DISCHARGE TANKS ONLgViC�A.PA..CITY MATERIAL - CAUSE(S) i <br /> 4 O TANKLEAK UNKNOWN - VUCI GAL, Q FIBERGLASS OVERFILL J <br /> uS � O Q RUPTUREFAILURE <br /> SII PIPINGLEAK' AGE 'YRS STEEL' <br /> Q CORROSION ';5K UNKNOWN <br /> a OTHER �UNKNOWN O OTHER _ O SPILL O OTHER <br /> w� CHECK ONE ONLY <br /> V UNDETERMINED O SOIL ONLY O ;GROUNDWATER O DRINKING WATER. (CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> ca. ,SITE INVESTIGATION IN PROGRESS(DEFINING E%TENTOFPROSLEM) CLEANUPIN PROGRESS O SIGNED OFF(CLEANUP COMPLETED OR UNNECESSARY) <br /> F <br /> U°� O NOACTIONTAKEN O POST CLEANUP MONITORING IN PROGRESS -O NO FUNDS AVALABLE TO PROCEED O EVALUATING CLEANUP ALTERNATIVES <br /> CHECK APPROPRIATE ACT)ON(S)(SEE BACK FOR DETAILS) d <br /> 0 CAP SITE(CD) Q EXCAVATE&DISPOSE(ED) �;O REMOVE FREE PRODUCT(FP) O ENHANCED BK)DEGRADATK)N(IT) <br /> X� Ej CONTAINMENT BAFIRIER(CB)- Q EXCAVATE&TREAT(ET) PUMP&TREAT GROUNDWATERINTI a REPLACESUPPLV(RS) <br /> O TREATMENT AT HOOKUP(H�l) a NO ACTION REOUIRED INA) O OTHER(01) }� <br /> ►�r,,� vx�c-�-r �r- cmN-i�4vkt�L�,.�L, L T4s r>-tau-�r� �� -rtt �v o rl�n ��,� <br /> $ <br /> ( <br /> I <br />
The URL can be used to link to this page
Your browser does not support the video tag.