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COMPLIANCE INFO_FILE 3
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2300 - Underground Storage Tank Program
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PR0231945
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COMPLIANCE INFO_FILE 3
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Last modified
12/19/2022 4:38:41 PM
Creation date
6/3/2020 9:55:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
FILE 3
RECORD_ID
PR0231945
PE
2361
FACILITY_ID
FA0003934
FACILITY_NAME
Lawrence Livermore National Lab - Site 300
STREET_NUMBER
15999
Direction
W
STREET_NAME
CORRAL HOLLOW
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
15999 W CORRAL HOLLOW RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231945_15999 W CORRAL HOLLOW_FILE 3.tif
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EHD - Public
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• <br /> INVENTORY RECONCILIATION <br /> TERLY SUMMARY REPORT FO <br /> Lawrence Livermore Emergency Generator Tanks <br /> Facility Name: National Laboratory Tank #/ Size Product <br /> Facility Address: <br /> P.O. Box 808, L-633 805-plul Un nipqpi <br /> a27-DMI ?Rn <br /> LiyQrmQrc. CA 24550 a34-plill 100 <br /> Telephone: (j] 5) 422-5167 280 Diesel <br /> Person Filing Connie DeGrange <br /> Report: <br /> I hereby certify under penalty of perjury that all inventory <br /> variations for the above mentioned facility were within the <br /> allowable limits for this quarter. (Ho in column 13 of the <br /> Inventory Reconciliation Sheet. ) <br /> Inventory variations exceeded the allowable limits for this <br /> quarter. I hereby certify under penalty of perjury that the <br /> source for the variation was not due to authorized (leak) <br /> release. (Yes in Column 13 of the Inventory Reconciliation <br /> Sheet) . <br /> List date, tank #, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> Date Tank Amount Reason <br /> 1. (See Attached Tablp.) <br /> 2. <br /> 3 . <br /> 4 . <br /> 5. <br /> Additional dates/amounts shall be continued on a separate <br /> sheet of paper and attached. <br /> If the source of the variation which exceeded allowable limits <br /> was due to a leak, the incident shall be reported to Public <br /> Health Services of San Joaquin County Environmental Health <br /> Division, within twenty-four (24) hours and an unauthorized <br /> release report submitted. <br /> The quarterly summary report shall be submitted within fifteen (15) days of <br /> the end of each quarter. Circle appropriate quarter. <br /> Quarter 1 - January---------->March <br /> Quarter 2 - April ----------->June <br /> Quarter 3 - July ------------>September <br /> <Quarter 4 - October --------->December� <br /> Send to: SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br />
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