Laserfiche WebLink
UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FOR I,OCA�AGENCY USE ONLY <br /> YES ® NO REPORT BEEN FILED? YES ® No )HEREBY c�axtw►rt�H�v sTau �saaw►iar nou�TOri�E <br /> DISTHIBI7 t(dN$I10WN aFI TFC R!5[AI ION SF T,ON 7HE BACK PACS OF THIS FORM <br /> REPORT DATECASE i <br /> 0 Ll <: � <br /> DATE <br /> NAME OF INDIVIDUAL FILING REPORT PHONE IGNATURE <br /> } Lynda S. Chalom (114 ) 572-7653 <br /> co <br /> w REPRESENTINGOWNER/OPERATOR Q REGIONAL BOARD COMPANY OR AGENCY NAME <br /> S LOCAL AGENCY Q OTHER Unocal Corpor tion <br /> W ADR SS <br /> 99 Imperial HWY, Room 2134 Brea, California 92621 <br /> STREET <br /> CRY STATE ZIP <br /> W NAME CONTACTPERSON M14) 572-7653 <br /> NE <br /> z� Unocal Cor oration ❑ UNKNOWN Lynda S. al m <br /> OCL 5 ADDRESS <br /> Cn <br /> cc 2929 Imperial HnAEE,Room 2134 Brea,,n,California 9„;621 ,P <br /> FACILITY NAME(IF APPLICABLE) OPERATOR PHONE <br /> z Unocal Service Station #5886 Darrell Eppley 1 (209) 473-7337 <br /> Q <br /> ADDRESS <br /> 2701 March Lane STREET Stockton Agan Joaquin Vallgy,,T,, CA 9�,�07 <br /> U) CROSS STREET <br /> I-5 <br /> O LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> zW San Joaquin County Pam Violet/Ms. Briggs (209) 468-0335 <br /> W <br /> Realth <br /> w REGK)NALBOARPHONE <br /> D <br /> CL< ( ) <br /> y (�) NAME QUANTITY LOST(GALLONS) <br /> D <br /> OZ J 87 Unleaded/ Gasoline k2 UNKNOWN <br /> mZ m <br /> C:O'- 92 Unleaded/ Gasoline :ENUNKNOWN <br /> Z DATE DISCOVERED HOW DISCOVERED INVENTORY CONTROL SUBSURFACE MONITORING 0 NUISANCE CONDITIONS <br /> La <br /> OMI 1 8. 9, TANK TEST TANK REMOVAL � OTHER G T g gP SL7 j t R <br /> a DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> >` UNKNOWN REMOVE CONTENTS [:]CLOSE TANK&REMOVE E]REPAIR PIPING <br /> x <br /> p HAS DISCHARGE BEEN STOPPED? Y F-1REPAIR TANK Q CLOSE TANK&FILL IN PLACE F CHANGE PROCEDURE <br /> o YES NO IF YES,DATE .1 j D Y 0 REPLACE TANK jo OTHER W i 11 Lig b a s g d upon <br /> SOURCE OF DISCHARGE CAUSE(S) investigationLU <br /> finding <br /> m F-� TANK LEAK UNKNOWN OVERFILL RUPTUREIFAILURE SPILL <br /> 0 v 0 PIPING LEAK F-� OTHER O CORROSION � UNKNOWN 0 OTHER <br /> W W CHECK ONE ONLY <br /> U UNDETERMINED SOIL ONLY O GROUNDWATER [:] DRINKING WATER -(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> W <br /> � NO ACTION TAKEN � PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED Q POLLUTION CHARACTERIZATION <br /> jy LEAK BEING CONFIRMED PRELIMINARY SITE ASSESSMENT UNDERWAY POST CLEANUP MONITORING IN PROGRESS <br /> O E] REMEDIATION PLAN CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) 0 CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION(S) 0 EXCAVATE&DISPOSE(ED) REMOVE FREE PRODUCT(FP) F--j ENHANCED BIO DEGRADATION(IT) <br /> (SEE BACK FOR DErn") <br /> a ZE-1 CAP SITE(CD) � EXCAVATE&TREAT(ET) PUMP&TREAT GROUNDWATER(GT) REPLACE SUPPLY(RS) <br /> 00 <br /> w a [7 CONTAINMENT BARRIER(CB) NO ACTION REQUIRED(NA) TREATMENT AT HOOKUP(HU) VENT SOIL(VS) <br /> Q <br /> VACUUM EXTRACT(VE) OTHER(OT) Will be based upon i nV s -i gation findings <br /> f2 SIR detected problems with the 87 and 92 tanks at this site. Unocal <br /> W contractor NDE Environmental will conduct tank and line testing 1/29/94. <br /> 3 Actions will be based upon the outcome of the testing. <br />�.. HSC 051&% <br />