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UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)I`CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES <br /> Q YES <br /> REPORT BEEN FILED 8 ®YES ® NO �}( .. t t HAVE 1NSTR THIS ORMATKY ACtXX2Dq Tt}THE: <br /> t�P).....:I SHEi"T IHE PAGE( THIS FORNR <br /> REPORT DATE CASE a <br /> % 313 0 9 4 EQ ..:..:...... <br /> o.. LMTE J <br /> NAME OF INDIVIDUAL FILING REPORT E S R <br /> } C. Susi Jackson ( 510)423-6577 <br /> REPRESENTING M OWNERIOPERATOR ❑ REGIONAL BOARD COMPANY OR AGENCY NAME <br /> R Q LOCAL AGENCY ❑ OTHER University of California <br /> LU <br /> aDDRESs <br /> P.O. Box 808, L-633 7000 East Avenue Livermore CA 94550 <br /> STREET :.:CM STATE =423-6577 <br /> NAME CONLTACT PERSON PHONE <br /> Dennis K. Fishem ❑UNK G. Susi Jackson ( 510 <br /> g ADDRESS' <br /> Q P.O. Box 808, L-668 STREET 7000 East Avenue Livermore C" 94550 <br /> ZIP <br /> FACILITY NAME(IF APPLICABLE) RATORPHONE <br /> Lawrence Livermore National Laboratory Dennis K. Fisher (510)422-3343 <br /> Site 300 Buildin 879 <br /> ADDRESS <br /> Corral Hollow Road South of Tracy San Joaquin <br /> STPW CITY COUNTY Zip <br /> H CROSS STREET <br /> Interstate 580. <br /> LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> W W San Joaquin County Public Health Services William Snavely (209 ) 468-0336 <br /> W REGIONAL BOARD PHONE <br /> g Central Valley RWQCB Susan Timm (916 ) 255-3057 <br /> y (�1 NAME QUANTITY LOST(GALLONS) <br /> Wo <br /> OW <br /> Diesel Fuel U <br /> NKNOWN <br /> � <br /> � <br /> UNKNOWN <br /> i DATE DISCOVERED HOW DISCOVERED ® INVENTORY CONTROL ® SUBSURFACE MONITORING ® NUISANCE CONDITIONS <br /> 2 0 4 3 ml 2 d 3 DI 9 4 y ❑ TANK TEST ® TANK REMOVAL ® OTHER <br /> DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> oJ M st.'.L UNKNOWN Q REMOVE CONTENTS ❑CLOSE TANK&REMOVE ❑REPAIR PIPING <br /> HAS DISCHARGE BEEN STOPPED Z ®REPAIR TANK Q CLOSE TANK&FILL IN PLACE ®CHANGE PROCEDURE <br /> ® :YES [:] NO IF YES.DATE O 3 1 d 8 el 9 Y14 YI <br /> REPLACE TANK OTHER <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> TANK LEAK UNKNOWN ® OVERFILL ® RUPTUREIFAILURE ® SPILL Rupture of <br /> ® PIPINGLEAK OTHERwateer ❑ CORROSION ® UNKNOWN ® OTHE e <br /> Ripw w CHECK ONE ONLY <br /> v 0 UNDETERMINED ® 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 CHARACTERIZZATION <br /> tu j2 <br /> cc y ❑ LEAK BEING CONFIRMED ❑ PRELIMINARY 317E ASSESSMENT UNDERWAY ® POST CLEANUP MONITORING IN PROGRESS <br /> U ® REMEDIATION PLAN CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) Q CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION($) REMOVE FREE PRODUCT(FP) Q ENHANCED BIO DEGRADATION(IT) <br /> RCK FM W ❑ EXCAVATE S DISPOSE(ED) <br /> z® ED CAP SITE(CO) EXCAVATE&TREAT(ET) PUMP&TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY(RS)a ® CONTAINMENT BARRIER(CB) NO ACTION flECOU1REO ® TREATMENT AT HOOKUP(HU) VENT SOIL(VS) <br /> Q VACUUM EXTRACT(VE) ® OTHER(OT)- Pump) water from excavation <br /> Tank 879-G1Ul and 879-G2U1 closure excavation on 3/18/94 resulted in rupture of <br /> W Building 879 city water piping. 3,000 'gallons were pumped out. A water sample <br /> collected for analyses by EPA Method 8260 (Volatile Organics by GC/MS) , and for <br /> Total Petroleum Hydrocarbons (TPH), showed 2 mg/L TPH ("weathered diesel fuel") , <br /> and BTXE values less <br /> M 05 Ia <br />