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JAN �f1 q <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)l CONgA�IN6RI � h <br /> EMERGENCY HAS STATE OFFICE DFGEN[,Y sERv3411It(]CALAG�(CY 11SE'.ONLY <br /> 171 <br /> YES ® NQ REPORT BEEN FRED T ❑YES <br /> _ }HERE9�fCE3�TlFY�€tAT�1N�-DfSR19tiTHl;fits]NFORbdAImFC/1CCG�iiDuar3OT <br /> REPORTOATE CASE) ISiR18[JtfE7NSH0WftSC<TFItM S#ETOnEIiBACKP µ <br /> . {_ <br /> 0 1 MI 2 d 1 9 2 yt BiGMEu <br /> NAME OF INDIVIDUAL FILING REPORT PHONE sr <br /> NATURQ <br /> ca <br /> Marc ZbWrodi. ('510 )429-8088 - , <br /> O REPRESENTING COMPANYORAGENCYNAME' ,. <br /> ® OWNERIOPERATOR ❑ REGIONAL.BOARD _ <br /> . LOCAL AGENCY Q OTHER Tank Protect-Engineering of Northern'CA <br /> LU ADDRESS <br /> 2821 Whipple' Road''.' Union CitSTREer .7 <br /> y.,_'CA 945,87 <br /> J NAMECONTACTPERSON .> PHONE <br /> co `y <br /> I:: M&M Automotive Service Q UNKNOWN. . zaxxy McLean (249-)-835-7 71,, <br /> yADDRESS <br /> 60 E. 10th Street Tracy, ,;,California �A5376 <br /> FACILRYNAME.(IFAPPLrABLE) OPERATOR 7. <br /> PHONE <br /> o M X09 'j635-;071 <br /> a ADDRESS <br /> 60 E 10th Street g, T c,nTracy coin Jaarn�i n <br /> yCROSS STREET - <br /> S <br /> d LOCALAGENCY AGENCrX ME CONTACTPERSON <br /> aPHONE . <br /> y <br /> Z5 S -�' vel 209 j468-3449 <br /> w REGIONAL BOARD - PHONE-- <br /> w (�) -Reg-49-0- <br /> 7 NAME QUANTITY LOST(GALLONS) <br /> LU0 <br /> Petroleum Hydrocarbons-- below 'UNKNOWN <br /> JM <br /> ❑ UNKNOWN y I <br /> = DATE DISCOVERED HOW D6�.+IERED ❑ INVENTORY CONTROL ❑ SUBSURFACE MONITORING,.' ❑ NUISANCE CONDITIONS �+ <br /> 2 * u r ❑ _ZA?QCTEST ® TANK REMOVAL. ❑ OTHER <br /> a DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY). 14 <br /> w [� UNKNOWN Q REMOVE CONTENTS ®CLOSETANK&REMOVE Q REPAIR PIPING <br /> p HAS DISCHARGE BEEN STOPPED T Q REPAIR TANK ❑CLOSE TANK a FILL iN PtACE ❑CHANGE PAMEDURE <br /> o ❑ YES ❑ NO IFYEs.DATE ui r r ❑REPLACE TANK Q OTHER <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> LU <br /> S ¢ ❑ TANK LEAK ® UNKNOMsi ❑ 'OVERFILL ❑ RUPTUREIFAILURE ❑ SPILL <br /> € . w Li ❑ PIPING LEAK ❑ OTHER ❑ CORROSION ❑ UNKNOWN' ❑ OTHER <br /> ' m a CHECK ONE ONLY <br /> ® UNDETERMINED ❑ SOIL ONLY ❑ GROUNDWATER Q DRINKING WATER -(CHECK ONLY IF WATER WELLS HAVE ACTUALLY sEEN AFFECTED) <br /> CHECK ONE ONLY <br /> w ® NO ACTION TAKEN ❑ PRL33aIARY SITE ASSESSMENT WORKPLAN SUI3MMM ❑ POLLUTION CHARACTERIZATION <br /> j Q LEAK BEING CONFIRMED ❑ PRIM-MNARYSITE ASSESSMENT UNDERWAY Q POST CLEANUP MONITORING IN PROGRESS <br /> U <br /> ❑ REMEDIATION PLAN ❑ CASE:mm(CLEANUP COMPLETED OR UNNECESSARY) CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION(S) =- AVATESDISPOSE <br /> (SM SAM FMD r^Lq ❑ (ED) ❑ REMOVE FREE PRODUCT(FP) E] ENHANCED flIO DEGRA(]ATION(IT) <br /> a - <br /> F ❑ CAP SITE(CD) ❑ EJT.IYATE a TREAT{ET} ❑ PUMP a TREAT GROUNDWATER-(GT)❑ REIPLACE SUPPLY(RS) <br /> a ❑ CONTAINMENT BARRIER{CB) ❑ liDACTK)N REQUIRED(NA) Q TREATMENT AT HOOKUP(HU) Q VENT SOIL(VS) , <br /> ❑ VACUUM ExTRACT(YE) ❑ OTHot(OT) <br /> On November 12, 1991 'AAA Tank Removal & Demolition- removed <br /> two underground � <br /> gasoline storage s, and Tit Frotect_E�ngineeriezg call ed soil samples. <br /> S, L -o�f�4- i.� z a-w I YLc/z-} 5�t�-�_rs e ss^ t�..r e- -1,� <br /> e ii+� - v� r L �L }�. a Ga.��A ri-I�r�.4fr o u iRe� <br /> 2�4v -91 <br /> ii <br /> } <br />