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UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FQR L6R AGENCY USE t)NlY <br /> REPORT BEEN FILED? <br /> F-1 YES NO YES ❑ NO tHE GERTIFYTHATiHAVEDISTRIBUTEDTHISINF.MM'rM:..CCORD.iMGTaT1E <br /> 18() THE UGTION SHEET ON THE SACK PAGE Df THIS FARM:;; <br /> REPORT DATEX. <br /> CASE <br /> 0 M18 M 0 8 9 5 Y OES# 009400 <br /> NAME OF INDIVIDUAL FILING REPORT PHONE ATURE <br /> m <br /> Lynda S. Chalom (714) 572-7589 <br /> REPRESENTING OWNERIOPERATOR ❑ REGIONAL BOARD COMPANY OR AGENCY NAME <br /> S ❑ LOCAL AGENCY ® OTHER Unocal Corporation <br /> ADDRESS <br /> 2929 Imperial Hwy, Room 2106 Brea, California 92621 <br /> STREET My STATE ZIP. <br /> J NAME CONTACT PERSON PHONE <br /> Z Unocal Corporation ❑UNKNOWN Ed Ralston e10 )277-2311 <br /> N a ADDRESS <br /> LU <br /> cc 2000 Crow CanyonPlace, te lace, Suite 400 SanRamon, California 94583 <br /> STREET <br /> FACILITY NAME(IF APPLICABLE) OPERATOR 77473-7337 <br /> Unocal Service Station # 5886 Darrell Eppley <br /> 0 <br /> ADDRESS <br /> 27.01 West March Lane Stockton, San Joaquin County,CA 95207 <br /> W STREET CITY COUNTY ZIP <br /> N CROSS STREET <br /> I-5 <br /> O LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> � <br /> w San Joaquin County E.H. Donna Heran/Michael Kith ( 201 468-3420 <br /> w w REGIONAL BOARD PHONE <br /> w (�3 NAME QUANTITY LOST(GALLONS) <br /> a> Hydrocarbons (gasoline and diesel) UNKNOWN <br /> m <br /> `" ❑ UNKNOWN <br /> F- DATE DISCOVERED HOW DISCOVERED <br /> Z ® INVENTORY CONTROL SUBSURFACE MONITORING NUISANCE CONDITIONS <br /> 0M 7M 3 lb 9Y 5,1 ❑ TANK TEST [:] TANK REMOVAL RKOTHER Soil S ampTi ng <br /> m DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> a <br /> w <br /> M d ol Y1 Y1 J UNKNOWN ❑REMOVE CONTENTS ❑CLOSE TANK&REMOVE ❑REPAIR PIPING <br /> 8 HAS DISCHARGE BEEN STOPPED? ®REPAIR TANK ❑CLOSE TANK&FILL IN PLACE ❑CHANGE PROCEDURE <br /> YES ® NO IF YES,DATE ® 7 3 1 9, 5y ❑REPLACE TANK MOTHERExc.avate contaminated soil <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> ¢¢ ❑ TANK LEAK UNKNOWN ® OVERFILL ❑ RUPTURE/FAILURE ❑ SPILL <br /> O ❑ PIPING LEAK ❑ OTHER ® CORROSION UNKNOWN ❑ OTHER <br /> w uj CHECK ONE ONLY <br /> o ❑ UNDETERMINED g][ SOIL ONLY ❑ GROUNDWATER ® DRINKING WATER -(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> ❑ NO ACTION TAKEN ❑ PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED ® POLLUTION CHARACTERIZATION <br /> r LEAK BEING CONFIRMED ❑ PRELIMINARY SITE ASSESSMENT UNDERWAY ❑ POST CLEANUP MONITORING IN PROGRESS <br /> O ❑ REMEDIATION PLAN ® CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTIONS) EXCAVATE b DISPOSE(ED) E:] REMOVE FREE PRODUCT(FP) ❑ ENHANCED BIO DEGRADATION(IT) I <br /> (BEE BACK FM DETARM <br /> ❑ CAP SITE(CD) ❑ EXCAVATE&TREAT(ET) ❑ PUMP&TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY(RS) <br /> a ® CONTAINMENT BARRIER(CB) ® NO ACTION REQUIRED(NA) ® TREATMENT AT HOOKUP(HU) VENT COIL(VS) <br /> ❑ VACUUM EXTRACT(VE) IM OTHER(OT) Wi11 be based on investigation findings. <br /> jJ e <br /> NSC 05( <br />