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COMPLIANCE INFO 2009 - 2013
Environmental Health - Public
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EHD Program Facility Records by Street Name
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CAPITOL
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6421
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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO 2009 - 2013
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Last modified
6/11/2019 11:57:34 AM
Creation date
4/10/2019 3:28:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009 - 2013
RECORD_ID
PR0231706
PE
2361
FACILITY_ID
FA0000485
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95242
APN
05532024
CURRENT_STATUS
01
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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5. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES [ ] <br />b. Ident ctor performing decontamination: <br />Name -c YC/c, ry O'l S�eJ v' `�,ps ,f l( < <br />Address/? 2 t %--� SY, Sv1,e fY 20 <br />c. Describe method to be used for decontamination: <br />NO [ ] <br />Phone lT q? x 2 2 7 5 <br />2/ <br />City V'r v Zip s <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone ( ) Hauler Reg# _ <br />Address City Zip <br />Permitted Disposal Site <br />6. a. Describe the method that will be utilized to purge and/or inert the piping: <br />b. Piping Hauler: <br />Name Phone (� <br />Address City Zip <br />Hauler Registration # (if hauled as hazardous) <br />c. Piping Disposal Site: <br />Name Phone (� <br />Address City Zip <br />EPA ID# (if transported to a permitted TSD facility) <br />7. Is the sampling firm an independent third party from the contractor? YES [ ] NO [ ] <br />a. Identify sampling firm: <br />Name Phone(_) <br />Address City Zip <br />b. Identify laboratory performing analysis: <br />Name Phone (� <br />Address City Zip <br />8. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br />9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name Hauler Registration # <br />Address City <br />b. If soil is not to be hauled, describe what will be done with it: <br />4 <br />Phone (_) <br />Zip <br />
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