Laserfiche WebLink
URF Final Step • - • Page 1 of 2 <br /> REGULATORS HOME I RESTART WIZARD LOGOUT <br /> UNAUTHORIZED RELEASE FORM WIZARD <br /> -=YOUR URF HAS NOT YET BEEN SUBMITTED TO GEOTRACKER=- <br /> CLICK ON "SUBMIT UNAUTHORIZED RELEASE FORM" TO SUBMIT THE URF. <br /> THIS WILL BE YOUR URF TRACKING NUMBER: 1006382584 <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASEICONTAMINATION SITE REPORT <br /> REPORT DATE HAZARDOUS MATERIAL INCIDENT REPORT FILED WITH OES? <br /> 03-03-05 <br /> L REPORTED BY- <br /> PRIMARY CASE WORKER <br /> CONTACT NAME INITIALS ORGANIZATION NAME EMAIL ADDRESS <br /> JIM BARTON CENTRAL VALLEY RWQCB(REGION 5S) <br /> ADDRESS CONTACT DESCRIPTION <br /> 3443 ROUTIER ROAD,SUITE A <br /> SACRAMENTO,CA 95827-3003 <br /> UNITED STATES <br /> II.RESPONSIBLE PARTY- <br /> REP.OF ORGANIZATION NAMED AS RP <br /> CONTACT NAME INITIALS ORGANIZATION NAME EMAIL ADDRESS <br /> GIL MOORE NEW WEST PETROLEUM <br /> ADDRESS CONTACT DESCRIPTION <br /> 183116TH STREET <br /> SACRAMENTO,CA 95814 <br /> USA <br /> 111.SITE LOCATION <br /> FACILITY NAME FACILITY ID <br /> NEW WEST PETROLEUM#1003 390001705 <br /> FACILITY ADDRESS ORIENTATION OF SITE TO STREET <br /> 6437 W.BANNER STREET <br /> LODI,CA 95242 _CROSS STREET <br /> SAN JOAQUIN COUNTY THORNTON ROAD <br /> V.SUBSTANCES RELEASED <br /> SUBSTANCE RELEASED DESCRIPTION QUANTITY LOST <br /> METHYL-TERT-BUTYL-ETHER(MTBE) UNKNOWNUNKNOWN <br /> VL DISCOVERY/ABATEMENT <br /> DATE DISCHARGE BEGAN <br /> UNKNOWN <br /> DATE DISCOVERED HOW DISCOVERED DESCRIPTION <br /> 05-14-04 GWM <br /> DATE STOPPED STOP METHOD DESCRIPTION <br /> V_11.SOURCE/CAUSE <br /> SOURCE OF DISCHARGE CAUSE OF DISCHARGE <br /> LINK LINK <br /> DISCHARGE DESCRIPTION <br /> VIII.CASE TYPE <br /> CASE TYPE <br /> OTHER GROUNDWATER(NOT USED FOR DRINKING WATER) <br /> D(.REMEDIAL ACTION <br /> htts:// eotracker.waterboards.ca. ov/urf3/urf final.as 3/9/2005 <br />