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UAn7IRONMIENTAL HEALTH DEPART ME T <br />SAN JOAQUIN COUNTYop <br />304 East Weber Avenue, Third Floor <br />Stockton, California 95202 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 <br />UST Consultation Checklist <br />Facility Parkwoods Gas & Liquor <br />Representative: Diana Huyenthanh Phan Date: 05/03/07 <br />Title: Owner <br />Facility Address: 1612 W. Hammer Lane <br />PR#: PR0231127 <br />CoeTask Comments <br />Underground Storage Tanks -Facility Form <br />Underground Storage Tanks -Tank Forms <br />Financial Responsibility/Letter from Chief <br />Financial Officer. Due every 12 months <br />Underground Storage Tank <br />Monitoring and Response Plans <br />Report #5021 Completed <br />Designated UST Operator Statement <br />Best Management Practices (BMP's) for Retail <br />Gasoline Outlets <br />Board of Equalization UST Storage Fee <br />Account Number <br />Monitorin2 Certification (go over last MC) <br />Du every 12 months \' <br />Spill Buckets <br />Sensors <br />Leak Detectors <br />Line Test Requirements (if needed or not <br />for pressurized piping) <br />Sensor/Leak Detector failures can have <br />emergency replacement with EHD permit <br />obtained within of replacement <br />All other work must have tHD permit <br />prior to work being performed <br />UST owner is responsible to see that EHD <br />permits are properly obtained <br />Secondary Containment Requirements <br />Go over last date - Due every 36 months <br />California EPA ID number <br />owliv <br />Hazardous waste generator <br />Hazardous Materials Management Plan <br />k v;sc �V 0 <br />Free UST and CUPA Classes Handout Provided <br />Consultation by: <br />