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Appendix C <br /> Operator's Monitoring Record for Unauthorized Release <br /> Submit to TAGG(L-633)of the EPD within five working <br /> days after detection of release <br /> Name: Telephone: <br /> Tank No: Piping leak? Tank leak? <br /> Type of hazardous substance: <br /> Concentration of substance: Quantity released: <br /> Date and time release discovered: <br /> Date and time release cleanup completed: <br /> Actions taken to control and cleanup the release: <br /> Disposal method: <br /> Disposal location (attach a copy of the hazardous waste manifest, if used): <br /> Describe actions taken to repair underground storage tank and to prevent future releases.If changes to the <br /> tank system were made,notify TAGG immediately [per H&S Code,Section 25286(a)]. Records of repairs must <br /> be kept on site for the remaining life of the tank(per 23 CCR 2712). <br /> Monitoring system reactivated or new monitoring system installed? <br /> How is the interstitial space currently monitored? <br /> ----------------- <br /> *Use this form if any of the following occur: <br /> (1) A leak of the primary tank contents into the interstitial space <br /> (2) A leak primary piping <br /> (3) Overspill of diesel fuel into overspill containment <br /> (4) Overfill of tank <br /> Attach to Operator's Monitoring Report <br />