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EMERGENCY Leek BdinA Confirmed Leak surpectdd at site„ bat has hart been confirmed;
<br /> Indicate whether: emergency e�Irnaa eiiersonrisl and ;+equipMerit were involves± Prelimanriif §ite;Ad.+gssment Waskplan 3abmitdet3 - woapiAVptoposal
<br /> at any time. if .>a, ;a tin.ar 3 u ' es l lrtcideatt P.epart shaszLd be filed"' requested afJwulamittsed by xesgans3bi4axtyo datdxm ne whether ground
<br /> with the State Clflioe of lascrgerrcy er iac (OBS)i.at 28t7f! Mradnwviaw i�uaid '" water Lias'laden; az ri11 ba, imisaoted ea a :rosin: of t...e kelesse.
<br /> Sacramento, CA 95832, 1C Diet ai the O rsgo�+t 1aim my iWobtained at 4 `* ��'"" /1�ce3limin<ary $iie:As e.sroent'Un3eracsv - imgladaeiitat�oii:cf 2, n.
<br /> your:, local.undergrt and stordg# taa�;�.p4it�.' :. agency. 14dicatet`wh.ethe7,i� � t £ri.Llutian Cltrract�riaat.3isn - x.... ..ii�le party i� iri. the.}axcat ass crE fully'
<br /> titltd Ok;S repos laa.r filed es of tm #kis xppor w. y, defining; the extent of aontamittg#on in 03011.:And gxqullA �atox and assessing
<br /> d .j' impartson Surface anddor ground hater.
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<br /> LOCAL AGENCY {l:".ILt' 1 a *. 9 �� T+�' +:raemddx aticn t I.rn rearf4diaLiou p ora $ub ittscl evaluating
<br /> long tent
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<br /> Tokavoi;d dup'irate iibti#iaaV,%On pursuant 0 jt+al�i and 5afq$y Carle,.:aecti s5}1x Tk fi xemedEst on options. Proposal and .impleMetibb:bit schedule fitr appro�riat a
<br /> 2514U.5, .a gave.�augont:employee sborilttrdign:raanc dr a the f`cisat in this,block. .; t r rumediati.on Options #ila€� sabrrt:.tted.
<br /> A slp,ns�ture here"" nes not mean brat t re Ie k a,;bean deteratined �r� rosd�a r!'' � wClertrt,.t Llndeana�+:- x�ple�e_nt,tinh at remadiat on g1nn,:
<br /> significant threat ta;htunan tiealt2t.ax g'_i�<tl o;i}y that notificat;issn' Pest leanrip i9crnl.iaring .in Para rs&a gxriodac around water, ax otktex
<br /> larva dz res Katie been followed if a 'tPsx p+ kncuia.toring. at site as T9.c as
<br /> tc vea£fy as loz etil lctate effec lvdness
<br /> ` ' r oaf remedial not ivi l es.
<br /> c$
<br /> ttt l OR2F i 3Y *
<br /> A. ;, i !Case C rued .et;i its t r 'award•affil local.agonncy.in r anaiixxende.that.no
<br /> Enter your nurne elwphe?ae Mt-*e.., :and adrr V .indicate palaich part C yore 3 further weir.Is is ale a .'ax•;st-at.t,h site.
<br /> zepresent and Provide Company or agency hasae
<br /> ie; ORTr'I 7HE'rOltt Sk. PROVIDED N TRIS F61MM.is Ilr`TM
<br /> EI3 F31t 4a£NEENAI
<br /> GPGSSTLLI PfiF Y �t # STATISTICAL i'POSES ONLY, AND is NOT TO ZE CORS1`RUE4 AS RE�RESEETIk7is i�E
<br /> g>zter name, telephone number, scojact persv[xO nd address of the party :,.: OFF!-_IAL rOSITION O_' AN( OVEct�".Ela'TAI AGENCY �
<br /> r esports,ib;e tar "he Leak. The r4as onsible party would norctially be:the UO*
<br /> aaner. i ` 1 rr1FDIAL AC iION �I
<br /> Irxd ate which actionrhmve been used tac'_sanup'nr reme4iate the leak.
<br /> SITE LOCATIDN a .j 5.eacriptiops..of alacinrs falln;"r. #
<br /> Enter i format;on regatdir$ the tkik taci.tity. At a mzntdOm, you must
<br /> provid mire facility na�gge and Full address. - Cap Site - iiistall horizontal imper'meabl.e layer to reduce rainfall
<br /> IMPLEMEN 2NG .AGENCIES ii- # ! . . Camta nmezit Barr! = iaistall vertical dike to block horiza,Ota movement of
<br /> Enteri amens of the local agency and Fag- ional Nates Quality Control.Hoard c s:tan, w a=.it,
<br /> n ol.ved, - # Lxcevate ars ; a e more contaminated sail and dispose -,i apnroved
<br /> US Ti Enter theiname�aaz Or zan itp' los .a, rLi J r�a+is sak,staiiet ixkvclvod, Rnbm land nfarrr i cit remb.>a sarFcamiaated sail ani. treat Ci..... se spreading
<br /> r ZO, aid'Tzi . e.
<br /> is.provided �cr infa`raelMon.:on wo"substluo;s if eppropria. e:: If more ti�pn �r ? Rer;nve'Free Product - remove floiating p clout from water ta17ii,
<br /> two substances leaked;_;list:alae t,.o of Mos"t cotxGern far aleatutls.. � � `1 Pu= and Treel GrotrnrlwaLer - generally V,vlayo4 to, remove, d 5—„led.
<br /> .,:r�”' Y c ori t use.it acts jh
<br /> DISCCVERY/AHsATkN? : '; �-1[,� r=.?i n.ed 35sacazaa._trvat aefpf any e�* i.tab2e: techxialogy toa;isrosrata
<br /> Provide infnrniation regsrctiug. +le`uiscau y arts.gbatsment: he 1ea}:. . +� s�4;cterirl, decanpcsa a©: of cotton�ants>
<br /> +i
<br /> Replace S�t?ly - p a ide a'ta.ra:atave water supply to.af£eaeted liartit4s.
<br /> Sc71tI%CF.JCAUSi # '`f w "� ,. Treatment 'at'Hyalccap: ins L water treWtmentd.evic'e#s. at.cadre;dvadliing or
<br /> indicate s,oszrc<s{sI nf:letrk. C'tecit'bt�x{ ). ndit;ating causes of lerak,, otter pl tc s,,'a£ ue
<br /> s, r "* ;g r55 yar,�u m Extract - use purrx. a t,irwr s tojraw air"t2trcrugla sas3.
<br /> SE TYPE 0 xy. F � yoirt Snxl bore !ole~: in oil to al. vol.atiiizatiaii of oonfi=tnantis
<br /> dicate the case. typo category for this leak. 11evk urm bm only. Ca { No Ac ti+ata Rrrgu2red 5n x:dc rt, ie rreitaar..; racltsiring no.rdmerdizrl aotzan,
<br /> type is roused an the most,seritive;xesouiCe adivc ed, For example, If r
<br /> Lath oil, .snei kruusri wrasEa. have hc?en. az:occecl, cash type iti}1 svcr:'Gr.n{uxs.,r cl.cs.±t'iS Use t.lrss ai;�ea•a to:9,aborate ati 4ny aspecs.s atf trite inc.ilde t.
<br /> Water". 7trdica a l?zinlaing Water" Duly iE oxta or Sucre mut o*rpsl <sz' r
<br /> domestic water tells hove aotuq..I. beoij affected, GritriiO.water" � SIGNATURE - Sarin the 1okitt An:the space provided:.;
<br /> designation dpta not brky that the affected water .cannot ha, or is ±'rat,
<br /> inert fuer drink a.g aater,�but'nnl}��laai water taell* Kara- not yet hese nwt5"C[tiE"UTION
<br /> affected!. It is unders't;nad that case type:.Vay ahaxrge upon', furtlxer if the form is completed.by 1-be tank owner Orlis 'agent;, "retain the lascopy
<br /> investigation. ` �j e end fcarwas'7 tis¢ enax zsaag copies detect to icor.local tank pertiittiris ageXIM '
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<br /> for dlstri3u:t on
<br /> CtJ}gpElrwl ST TiiS * .}, - xr 1 Oxis nal Local .T3 r Feim tting:.r.,gsncy
<br /> ludicat.is the category welicii'?iest,descraor +}r_ +.,.r:renc status of the case; x;. 2. Stab, Water Rpsaur:c.s Conur�cn_. Srard, .vIlsidn ti'f. Clean water Frugrams,
<br /> Check ane I>ax only. I� :,i �..�4hauld Le }aLi.v tc the'c, I type, F,bs Q.' Undergraursdl Stox�ge l-a,zk _rrgaam,. P.C. ;trot �4rt312, Sscramdzito:, CA �}t<Z�iy-
<br /> ex6olple i , P7As Lyre x$ !srh YZ`il a'4��f:EL G:£n "C..ur'ret iLi itt+.w r' S2'Jttar{� rder ,
<br /> to t:hG st.itus tr t_u ground » ter: ss esu a,aticn or c.r.e.trtup, Tris Opposed tnt 3 -arses 'r;wtcr Qt(atity Cantral Briaxa .
<br /> klrrr4 of aiW, U ,,crip.ions::ef tangy ares Ia's'Qw: k 2nasa Halt' reef vet axed to nt�.3ca,+ of uupliisors :fir filre3r3asiF.azeo z
<br /> 1 r.:.rri YE t'A'Gp3 ss w r.+r3 {. _,%_f_.._..::�n...._, 1}.
<br /> i.> <c s r r K hp act sear. a heats then t ze5rrotrt,;i l Pr:rkvt: �d 5, hvru.i.re.,1. _i,. 3 Y p. c.y,,
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