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REMOVAL TEMP CLOSURE 1998
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231830
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REMOVAL TEMP CLOSURE 1998
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Last modified
7/6/2020 4:43:28 PM
Creation date
11/7/2018 9:31:13 AM
Metadata
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Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
TEMP CLOSURE 1998
RECORD_ID
PR0231830
PE
2361
FACILITY_ID
FA0004030
FACILITY_NAME
THREE PALMS GROCERY
STREET_NUMBER
6732
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10110001
CURRENT_STATUS
02
SITE_LOCATION
6732 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
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\MIGRATIONS\W\WATERLOO\6732\PR0231830\TEMP CLOSURE 1998.PDF
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EHD - Public
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II. GENERAL INFORMATION: <br />1. Obtain an EPA Site Number from the Department of Toxic Substances Control (800) 61 -TOXIC for temporary <br />hazardous waste removal activities associated with underground storage tank (UST) removals. <br />2. Disposal Information: Public Health Services Underground Storage Tank Disposition Tracking Record (UST <br />Tracking Record, page 10) shall accompany each tank removed from site. Tank(s) will be issued an identification <br />number which PHS-EHD's representative will note on the UST Tracking Record. Contractor will affix same <br />identification number onto tank end using fluorescent spray paint. Contaminated tanks and/or piping are to be <br />transported under Hazardous Waste Manifest by a state registered hazardous waste hauler. <br />3. Contractor to Provide: Combustible/Flammable gas detector (to verify the Lower Explosive Limit (LEL) <br />atmosphere and oxygen level of tank prior to lifting from excavation), adequate number(s) and appropriate type(s) <br />of fire extinguisher(s), barriers to secure the area as necessary to minimize traffic and pedestrian interference, and <br />fluorescent spray paint to affix tank identification numbers. It shall be the project manager's responsibility for <br />compliance with all health & safety regulations and requirements, which shall be strictly adhered to at all times <br />during the course of the closure activities. <br />4 The PHS-EHD permit shall be on site during tank excavation and removal. <br />5. Any changes in this document shall be approved by PHS-EHD prior to initiating work. <br />6. Closure -in -Place: If Closure -in -Place is the suggested method of abandonment, complete form <br />EH 23 039 and submit written approval from the local Fire Department. <br />7. Temporary Closure: If Temporary Closure is the suggested method of abandonment, complete <br />and submit this form and a written approval from the local Fire Department. <br />8. The following documentation shall be submitted within 30 days of the tank removal date: <br />a) Analytical results, mailed directly from laboratory to PHS-EHD, including a chain of custody and quality <br />assurance and quality control (QA & QC). <br />b) UST Tracking Record Sheet(s) and/or Tank Hazardous Waste Manifest(s). <br />C) Tank Closure Certification Form (DTSC form 1249). <br />d) Hazardous Waste Manifests for piping, rinsate, residual fuel, or waste oil receipt. <br />e) Submit the backfill excavation certificate as required by San Joaquin County and the incorporated City <br />Building Departments. This report will be referred to the appropriate agency for their review. <br />A site which has had UST(s) removed, shall not be considered for final closure until the above items are <br />submitted for review. <br />III. SITE MITIGATION: <br />In the event contamination is observed, confirmed or suspected as a result of a leaking UST system it is the <br />responsibility of the owner or operator to submit a workplan to PHS-EHD Site Mitigation Unit prior to initiating <br />any assessment or remediation activities. To minimize delays, a Corrective Action Plan may be submitted <br />concurrent with tank closure or installation plans. Address one copy of the Corrective Action Plan to the Site <br />Mitigation Unit for review. For further assistance contact the Site Mitigation Unit at (209) 468-3450. <br />EH 23 046 (Revisedl0/19/98) Page 2 <br />
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