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SITE INFORMATION AND CORRESPONDENCE
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2900 - Site Mitigation Program
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PR0526486
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/28/2020 4:21:19 PM
Creation date
5/11/2020 11:38:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0526486
PE
2965
FACILITY_ID
FA0017927
FACILITY_NAME
LOCKEFORD COMMUNITY SVCS DIST
STREET_NUMBER
17725
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237
APN
05303039
CURRENT_STATUS
01
SITE_LOCATION
17725 N TULLY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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n FACILITIES INSPECTION REPORT <br /> OFFICE NO: SS <br /> i <br /> PCA System Task No: <br /> /2 l <br /> INSPECTOR: TIMOTHY R. O'BRIEN <br /> 58=90102002 LOCKEFORD CSD, LOCKEFORD WWT&DISPOSAL <br /> WUS NUMBER OF AGENCY OR PARTY RESPONSMIJ.E FOR DISCHARGE <br /> NAME OF FACILITY <br /> Pn BOY 7 1" N. TL'LLY RD <br /> NPDES NUMBER AGENCY STREET FACILITY STREET <br /> nnn?Rt r nruFFnRn (-A 01;n r nryFFrnzn Sa <br /> (YY)iNiM)iTYPE) AGENCY CITY AND STAT FACILITY CITY AND STATE <br /> SCHED LNSPECT DATE <br /> GENER_�L �tANAG R JOE SALZ_ M <br /> AGENCY CONTACT PERSON FACILITY CONTACT PERSON <br /> pZ/Z 3`c�o (?09)727-5015 Z.,-�/ 7Z--7 .fn' <br /> ACTUAL INSPECTION DATE AGENCY PHONE NO. FACILITY PHONE NO. <br /> TNCPF.C'TION TVPF. (Check Onel <br /> (A1) "A" type compliance--Comprehensive inspection in which samples are taken.(EPA Type S) <br /> "B"type compliance--A routine nonsampling inspection.(EPA Type C) <br /> (02) Noncompliance follow-up--Inspection made to verify correction of a previously identified violation. <br /> (03) Enforcement follow-up--Inspection made to verify that conditions of an enforcement action are being met. <br /> (04) Complaint--Inspection made in response to a complaint. <br /> (OS) Pre-requirement--Inspection made to gather info,relative to preparing,modifying,or rescinding requirements. <br /> (06) Miscellaneous-- Any inspection type not mentioned above. <br /> If this is an EPA inspection not mentioned above,please note type. <br /> (e.g.-biomonitoring,performance audit,diagnostic,etc.) <br /> (Type) <br /> N Were VIOLATIONS noted during this inspection? (yes/NoTendin,g Sample Results) <br /> Was this a Quality Assurance-Based Inspection?(Y/INT) <br /> Were bioassay samples taken?(N=No.If YES,then S=Static or F=Flowthrough) <br /> INSPECTION SUMMARY (REQUIRED) (100 character limit) <br /> INSPECTOR'S DATA: <br /> INITIALS —�'n SIGNATURE DATE 3 4 nd <br /> For Internal Use Reviewed By:ll) \� (2 (3)) <br /> Reg.SWIM Coordinator <br /> SWIM Data Entry Date: Regional Board File Number: <br />
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