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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.sogov.org/ehd <br /> RECORDING REQUIREMENTS <br /> FOR UNAUTHORIZED RELEASES <br /> An owner or operator is required to record all releases from the primary containment, as approved in <br /> this facility's Response Plan. This form may be used to meet the recording requirements* if all of the <br /> conditions below are true. <br /> 1. The owner or operator can clean up the release from the primary containment <br /> within 8 hours after the release was detected or should have been detected. T F <br /> AND <br /> 2. The release has not escaped the secondary containment. y F <br /> AND <br /> 3. The release does not increase the hazard of fire or explosion. y F <br /> AND <br /> 4. The release does not cause deterioration of the secondary containment. y F <br /> If all conditions above are not fulfilled you must report the release to the San Joaquin County <br /> Environmental Health Department and other agencies as appropriate. Date of release: 6/6/2024 <br /> Operator's name: Quik Stop Markets, Inc. Phone Number: 1-800-225-9702 <br /> Facility name: Quik Stop 132 Facility Address: 3555 W. Hammer Ln <br /> Hazardous substance found in the secondary containment: Gasoline <br /> Quantity: 1 Quart Concentration: 100% gasoline <br /> Description of the actions taken to control and clean up the release: <br /> Powered of Turbine motors Removed gasoline via hand pump. Placed in Haz Mat Drum. <br /> The method and location of disposal of the released hazardous substance: On Site Haz Mat <br /> Drum <br /> Description of actions taken to repair the UST and to prevent future releases. Attach a copy of the <br /> maintenance receipt: Replaced leaking cooper fittings and tubing on Leak detector vent piping <br /> Powere on turbines and tested for leaks <br /> Describe how the monitoring system was reactivated after repairs or replacement: <br /> After fuel was removed alarm self cleared <br /> Attach printout from continuous monitoring system, maintenance receipts, manifests, photos, etc. <br /> Retain this document with your monitoring records for review during the annual inspection by our department. <br /> *See the California Code of Regulations, Title 23, Section 2651 and California Health & Safety Code Section <br /> 25294 for further requirements. <br />