Laserfiche WebLink
1� / u3`i <br /> UNDERGROUND STORAGE TANK UIQ'AUTHORIZED RELEASE (LEAK) / CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES S{ `fI.JILaEtJCY USI:.ONLY <br /> REPORTBEEN FILED? )�FL#iE6Y EfTY YHAYIAM ADESIGNATED GOVERNMENT EMPLOYEE AND TFfATI <br /> O YES ® NO O)ES O NJ j+J }}�(�QR'#�#j 'hISIY QI3MATICN TO LOCALOFACIALS PURSUANT TO SECTION <br /> 7bt977ffYN�3itdLikIANUSAf`ETYCODE '. <br /> REPORT DATE(MM-DD-YY) CASE# <br /> 04/19/91 16613 SGNE DATE <br /> NAME OF INDIVIDUAL RUNG REPORT PHONE SIGN TORE _ <br /> > Elaine Lavine (415)-571-2482 <br /> O REPRESENTING OX OWNIROPERATOR REGIONAL BOARD COMPANY OR AGENCY NAME <br /> O_IXALAGENCYOQTHEq ARCO Products Company <br /> ADDRESS P.O.Box 5811 San Mateo CA 94402 <br /> STREET CITY STATE ZIP <br /> 9 NAME CONTACT PERSON RHONE <br /> z ARCO Products Company OLNKNOWN Elaine J.Lavine (415)-571-2482 <br /> Oa ADDRESS San Mateo CA 94402 <br /> STREET <br /> a PO BOX 5811 EET v.Compl.Dept GIT, STATE ZIP5TREET <br /> FAQUTY NAME OF APPLICABLE) OPERATOR RHONE <br /> $ ARCO FACILITY 00434 EDWARD D SEQUEIRA (209)-333-0141 <br /> 6 ADDRESS 501 W.KETTLEMAN LANE LODI SAN JOAQUIN 95240 <br /> 01 STREET CITY COUNTY ZIP <br /> 10 CROSSSTREET <br /> y HUTCHINS/W KETTLEMAN <br /> 2 LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> ws SAN JOAQUIN COUNTY PUBLIC HEALTH DOUG WILSON (209)-468-3420 <br /> �jZ REGIONAL BOARD PHONE <br /> CENTRAL VALLEY REGION LEE BOGGS (916)-361-5600 <br /> r) NAME QUANTITY LOST(GALLONS) <br /> w <br /> GASOLINE O UNKNOWN <br /> ro (1J QUANTITY LOST(GALLONS) <br /> N <br /> O UNKNOWN <br /> DATE DISCOVERED(MM-0D-YY) HOW DISCOVERED OINJENTORY CONTROL O RMURFACE MONITORING ONUISANCE CONDITIONS <br /> �Z 04 7/1991 OTANKTEST OTANCREMOVAL Ox OTHER GAS DELIVERY <br /> >� DATE DISCHARGE BEGAN(MM-DD-YY) METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> Ol <br /> 04/17/1991 OLNKNOWN REMOVE CONTENTS REPLACE TANK OCTOSE TANK <br /> HASDISCHARGE BEEN STOPPED 4 O REPAIR TANK O REPAIR PIPING OCHANGE PROCEDURE <br /> ®YES ONO IFYES,DATE 04/17/1991 OX OTHER <br /> SDU7CE OF DISCHARGE CAUSE(S) <br /> ¢N OTA KLEAK O UNKNOWN 0 OVERFILL 0 RiPTUREIFAILURE O SPLL <br /> 20 OPPNG LEAK OX OTHER O CORROSION OUNKNOWN OOTHER <br /> y w <br /> CHECK ONE ONLY <br /> V QUNDETERMINED E:]SOL ONLY 0GROUNDWATER ODRNQNGWATER-(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> '- <br /> CHECK ONE ONLY <br /> r 7X NO ACTION TAKEN O PRELN NARY SITE ASSESSMENT WORKPLAN SUBMITTED O POLLUTION CHARACTERIZATION <br /> yO LEAKBEING CONFIRMED O PRELMNARY SITE ASSESSMENT UNDERWAY O POST CLEANUP MONITORING IN PROGRESS <br /> O REMEDIATION PLAN 0 CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) O CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTON(S) [-]EVACUATE AND DISPOSE(ED) O REMOVE FREE PRODUCT(FP) [—]ENHANCED BIO DEGRADATION OT) <br /> O O CAP SITE(CD) EVACUATE AND TREAT(ET) Q RNP&TREAT GROUNDWATER(GT) O REPLACE SUPPLY(RS) <br /> �F <br /> a �CONTAINMENT BARRIER(CB) QX NOACTION REQUIRED(NA) O TREATMENTAT HOOKUP(HU) QVENTSUPPLY(VS) � <br /> O VACUUM EXTRACT(VE) 0 OTHER(OT) I <br /> CALZONE DRIVER OVERFILLED THE TANK GAS SPILLED FROM HOSE WHEN DRIVER UNHOOKED HIS VAPOR <br /> TUBE. SPILLED WAS CLEANED WITH ABSORBENTS. SAN JOAQUIN COUNTY AND OES NOTIFIED. <br /> s <br /> O <br /> 0 <br />