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COMPLIANCE INFO_2013-2018
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COMPLIANCE INFO_2013-2018
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Last modified
12/4/2023 3:54:13 PM
Creation date
6/23/2020 6:52:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2018
RECORD_ID
PR0231784
PE
2361
FACILITY_ID
FA0003834
FACILITY_NAME
PACIFIC AVE CHEVRON
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
097-410-48
CURRENT_STATUS
01
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231784_6633 PACIFIC_2013-2018.tif
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EHD - Public
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San Joaquin County <br />Environmental Health Departmen! <br />1868 E. Hazelton Avenue <br />Stockton, California 95205-6232 <br />Website: www.sjgov.org/ehd <br />Phone: (209) 468-3420 <br />Fax: (209) 464-3433 <br />DIRECTOR <br />Donna Heran, REHS <br />PROGRAM COORDINATORS <br />Robert McCiellon, REHS <br />Jeff Carruesco, REHS, RDI <br />Kasey Foley, REHS <br />Linda Turkatte, REHS <br />is 10 W 1 tri 0 M <br />9 M <br />• 11:161011111111] 1. 0 41:j I U -.4 :1 gll I -a ug -.4 17,11 <br />1. Submit all information in triplicate. Answer all questions, leaving no blanks. One copy will be returned to the <br />applicant with comments. <br />2. Include a detailed site map on a separate sheet of paper showing all work to be done. Include the location of <br />the tanks(s), piping, all tank -related appurtenances, streets, adjacent properties (north toward the top of the page), <br />nearby septic tanks, leachfields, water wells, buildings, underground public utility lines (including water, sanitary <br />sewer and storm sewer), and distance of piping from tank to dispensers. If underground utilities are not included <br />on the site map, you must state in writing that USA Dig will be contacted prior to excavation activities. <br />3. Complete pages 3-6, "APPLICATION FOR UNDERGROUND STORAGE TANK RETROFIT OR PIPING <br />REPAIR PERMi-r,. RO—T-E-1 If sampling is required, sampling firm shall be an independent third 12grty from the <br />contractor performing the work. <br />4. Complete page 7, "Authorization to Release". This form must be signed and dated by the <br />OWNERIOPERATOR of the facility. <br />isroTro, =MMI 11; 11 A <br />6. If performing any excavation activities, and the facility is located outside of the city limits, submit a "Backfill <br />Excavation certificate" as required by the San Joaquin County Building Department. If a "Backfill Excavation <br />Certificate" is required by any incorporated areas (cities), submit to the appropriate City Building Departments, <br />pursuant to the Uniform Building Code STD 70-11. <br />7. The maximum review time for Plan Review is 16 working days from receipt of the adequately completed plan If <br />gross deficiencies are identified, an addendum will be required with a $125.00 per hour fee and the review will <br />begin on the date of resubmittal. <br />8. Advance inspection notice of at least 48 hours is required by the Environmental iNealth <br />Department (EHD). <br />9. Contractor to Provide: Combustible/Flammable gas detector (to verify the Lower Explosive Limit (LEL) <br />atmosphere and oxygen level), adequate number(s) and appropriate type(s) of fire extinguisher(s), and barriers to <br />secure the area as necessary to minimize traffic and pedestrian interference. It shall be the project manager's <br />responsibility for compliance with all health & safety regulations and requirements, including confined space <br />requirements, which shall be strictly adhered to at all times during the course of the underground storage tank <br />(UST) activities. <br />[ ] 10. The EHD permit shall be on site during all LIST permit -related activities. <br />
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