Laserfiche WebLink
UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FOR LOCAL;AGENCY:USE ONLY <br /> REPORT SEEN FILED7 <br /> ❑ YES [ NO ❑ YES ❑ No HERESY CERTFY t HAVE D TR THS IIEORMATIdd TO�}. ': <br /> REPORT DATE <br /> OISTAG(gM SHOWNON THE INSTRUCTION SHEET ON THE SACK PAGE OF?THG,--- <br /> CASE a _:..:. <br /> OA 7 mi 1 d 1 d 974 sl�aEn DATE <br /> NAME OF INDIVIDUAL FLING REPORT PRE S <br /> C. Susi Jackson ( 510)423-6577 <br /> w REPRESENTING -1 OR AGENCY NAME <br /> ¢ ® OWNERIOPERATOR ® REGIONAL BOARD <br /> S ❑ LOCAL AGENCY ❑ OTHER University of California <br /> ¢ ADDRESS <br /> P.O. Box 808, L-633 7000 East Ave. Livermore <br /> A 94550 <br /> m NAME CONTACT PERSON PHCNIE <br /> z rA Dennis K. Fisher ❑UNKNOWN C. Susi Jackson X10 )423-6577 <br /> CL ADDRESS <br /> Q P.O. Box 808, L-668 7000 East Ave Livermore CA 94550 <br /> My STATE <br /> FACILITY NAME(IAA <br /> F PLICABLE) OPERATOR PHONE <br /> $ Lawrence Livermore National Laboratorsit, 300y <br /> (510 ) 422-3343 <br /> < ADDRESS <br /> o Corral Hollow Road South of Tracy San Joaquin <br /> W STREU Crry <br /> y CROSS STREET <br /> Interstate 580 <br /> i LOCAL AGENCY AGENCY NAME CONTACT PERSON p <br /> HONE <br /> w- San Joaquin County Public Health Services William Snavely (209 ) 468-0336 <br /> W LL. REGIONAL BOARD PHONE <br /> M a Central Valley RWQCB Susan Timm (916 ) 255-3057 <br /> N ( <br /> wa NAME QUANTITY LOST <br /> > Diesel Fuel ❑ <br /> UNKNowNm <br /> N <br /> ® UNKNOWN <br /> w DATE DISCOVERED HCriY DISCOVERED ❑ INVENTORY CONTROL ❑ SUBSURFACE MONITORING ❑ NUISANCE CO <br /> NDITIONS <br /> W 0 j 7.1 0 1 ol 9 4 y ❑ TANK TEST ® TANK REMOVAL ❑ OTHERReview Soil Sample Analyses <br /> m DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> a <br /> LU <br /> �' UNKNOWN F7REMOVE CONTENTS ®CLOSE TANK t REMOVE ❑REPAIR PIPING DISCHAIK?E BEEN STOPPED T ❑REPAIR TANK ❑CLOSE TANK NL FILL IN PLACE a CHANGE PROCEDURE <br /> o ® YES (_] NO F YES,DATE 0.1 6 j 2 2 d 9 vI 4 d ❑REPUACE TANK ❑OTHER <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> U ❑ TANK LEAK ❑ UNKNOWN ❑ OVERFILL ❑ RUPTURE/FAILURE ❑ SMLL <br /> H ❑ PIPING LEAK ® OTHER (❑ CORROSION Q UNKNOWN ❑ OTHER <br /> H wa CHECK ONE ONLY <br /> v ❑ UNDETERMINED ❑ S00.ONLY ❑ GROUNDWATER ❑ DRINKING WATER-(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> _ <br /> �' <br /> 2 ® NO ACTION TAKEN Q PRELIMINARY SITE ASSESSMENT WORKMAN SUBMITTED ❑ POLLUTION CHARACTERIZATION <br /> y ❑ LEAK BEING CONFIRMED ❑ PRELIMINARY SITE ASSESSMENT UNDE ❑ POST CLEANUP MONITORING IN PROGRESS <br /> o ❑ REMEDIATION PW1 ❑ CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION(S) -1 b DISPOSE <br /> ase GftzfM0"w ❑ (ED) ❑ REMOVE FREE PRODUCT(FP) ❑ ENHANCED BIO DEGRADATION((T) <br /> Q <br /> p ❑ CAP SITE(CO) ❑ EXCAVATE&TREAT(ET) ❑ PUMP&TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY(RS) <br /> 20 <br /> W< <br /> ❑ CONTAINMENT BARRIER(CB) [— NO ACTION REQUIRED(NAI ❑ TREATMENT AT HOOKUP(1J) ® VENT SOL(VS) <br /> ❑ VACUUM EXTRACT(VE) R-1 OTHERroTIRemoyed tank ;1 gravel a and ani 1 <br /> Analyses of the soil sample collected from soil and fill gravel excavated at the <br /> W underground diesel fuel tank 827-D2U1 closure site showed ll.Omg/kg diesel fuel in <br /> msoil. No diesel fuel was detected in the soil sample collected in the bottom of the <br /> excavation. BTXE was not detected in either sample. <br /> HSC as("M <br />