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COMPLIANCE INFO 2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PATTERSON PASS
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25775
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2300 - Underground Storage Tank Program
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PR0231708
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COMPLIANCE INFO 2018
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Last modified
5/14/2019 2:26:33 PM
Creation date
2/26/2019 12:19:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018
RECORD_ID
PR0231708
PE
2361
FACILITY_ID
FA0003619
FACILITY_NAME
ARP MINI MART CORP
STREET_NUMBER
25775
Direction
S
STREET_NAME
PATTERSON PASS
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
20910004
CURRENT_STATUS
01
SITE_LOCATION
25775 S PATTERSON PASS RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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KBlackwell
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EHD - Public
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5. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES`K NO [] <br /> b. Identify contractor performing decontamination: I <br /> Name.__�fii lIS �'v\v iX0Y)Me .�✓1 1-Y\L Phone 6Nk <br /> Address 3330 (2trn e,avh 4V- �)', (1,4'1'}e CSD City Mn ip cjsk- <br /> c. Describe method to be used for decontamination: <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage& Disposal Facility: EPA ID CAD983653627 & MC CA0109650 <br /> Hauler Name J=-W M Phone W16(- 2494.0 Hauler Reg# DTSC 3175 <br /> Address 9 3 0 AM PA & c e City Zip <br /> Permitted Disposal Site Crosby an Overton 1610 W 17th St., Long Beach, CA 90813 P:562-432-5445 <br /> 6. a. Describe the method that will be utilized to purge and/or inert the piping: N f <br /> ti. Piping Hauler: <br /> Name Phone ( ) <br /> Address City Zip; <br /> Hauler Registration#(if hauled as hazardous) <br /> c. Piping Disposal Site: APR 27 2018 <br /> Name Phone 11MENTAL <br /> Address City :!'::Qn QTMENT <br /> EPA ID#(if transported to a permitted TSD facility) <br /> 7. Is the sampling firm an independent third party from the contractor? YESQ(� NO [] <br /> a. Identify sampling firm: /^ _ / . <br /> Name S ATu S Y/n\/1 ywY)M evytat. Lh Phone(5 3) -G X16'- 266 <br /> Lt- <br /> Address 333� C_ar eW n >7'e �-- 9- i V ,Sh SSP city 6 hityyin (�QYF-zip q,-6& 2— <br /> b. Identify laboratory performing analysis: <br /> Name /�I�►1G} ArAly'ri '� Phone (U-) 3916- 909-9 <br /> Address q�yC� �f11� nCq �'�C►� City C v{--.p Rs6_��'f" <br /> 8. Describe, in detail, how the soil and/or water sample(s)beneath the piping or dispenser will be obtained: <br /> Sn:\ Sc,.,nal� �+}� h� C��\zc� in C'�►v��r✓SS 5��1�6�SS Sfr_�-�%'�,S , y.�'}v�� c� S �i+.LE'� <br /> �e�vy+�e,>'•�k.- �1"�J.� 4��wrv�e-�w�� 51�+'� G��\\ t,� �.Y�y�.t,. .�Ry sem �'o Cdilr�,4- <br /> s'� <br /> 9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br /> Name Integrated WasteStream Mgmt. Hauler Registration# DTSC 3175 Phone4( O8)813-9428 <br /> Address 930 Ames Ave. City Milpitas Zip 95035 <br /> b. If soil is not to be hauled, describe what will be done with it: <br /> If soil is not contaminated from lab results it will be send to nearest dump. <br /> EH230038(revised 7-26-2016) 4 <br />
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