Laserfiche WebLink
MAO- <br /> _ L"•�.•'.:i:_ -w�-.'� •-_�+.sem• ! • <br /> cRGRONNO STORAGE:TANK 11NALG'M&IZED RELEASE(LEAK) CONTAMINATION SITE REPORT <br /> EUF�GiIvCY �`' `e'rr:�"r"rw�;- •.�14:-:�.� (LEAK) <br /> ilAS STA Eu£TL7pA.y <br /> ❑YES ® '7 i:%�RF7�CRTIEFxS�ED1 �..` „s��� FCR LOCAL ACEKCTMEOUT, <br /> �-��, "r'.a` T�. k�Sc.:;�]YEI.:�.7+J:�• .IHfRE8YCFAfrtY.IHtf..fA1jA DES)WTEbGOV&^MkW EMPLOYEE'hhn iyLl7 i}[AYE <br /> RFrR,OATc _�` _ - !- ^ + �' Ffs�RiEO.f}iS HFCR11AT1aFf,TO COCA CfFICJii PLFi5UJ4ti7 TC SFC'pN 25=7 OF <br /> THE SAFTYOCOE <br /> rlNA <br /> .Cr <br /> WO''�N•CCFL1nQ REPOT _ _ SYMf�T'.,.ew ...__ ........,,._.,-•z1:..r:;:<^-::.�.:::Yr_� -.r_� <br /> _:;�.-:'`-».- r._ _.. ti+'i_'_'j;.�n;�:'. �.r_•SICJiATURE <br /> AEPAESEEr n"o•.�.•:i-Q,'OWFEROP• III'.= "��G�J T Y y'�.IT/.�•N L�4%�.. /�i'iJ0 y.'(•s L.V . . a <br /> EAATGq;❑ FEd+ONACSOARD• C06WANYORACENGYNAU1 L' r Gf• <br /> _... p LCChL?i�laCl a 0T1fE �.:e� ,t_ � .- ....-._ :: _ -�.'=i•^:r,}-:.�L.;...�.:• :. !/ <br /> ¢ ADOAESS R_ r fi'�/' <br /> '• I�c4t <br /> u� <br /> ax <br /> NAmF o, 'l3 �;vv f..�� ;7e��-7v.,I - -rC - .a: .j.w 4��,z�•f <br /> t3 ' r is n- .. } •' CONTA6T PEASOrr _ •irarY <br /> ACOAEss u+nrowri �. I F� /P�ryo 1 <br /> ' - ✓••1�'V n <br /> I e,trr. urt -SfJ! ' ✓i�- r . <br /> GAC;ITYNAAIE(FAPPLICA3LE). i,ar[ ••• /�.)� L <br /> OPERATOR <br /> PHONEs <br /> cAasssrf :! nt17TGUi•t-� : f,r ��✓lr 'd.✓ �•/4 <br /> RC�T • TYPF OF AREA❑COCIIAEAC AL TiDUSTANLC WRAL 'IiPEOFBUS&ESS ❑RIrTAX FUEL STATYCH <br /> • .'>• ❑AES[)ENTNL ❑OT)LER 0 ❑CTHER <br /> 4 COCAC AG"cNCY AGENCY N+GE ^�--�•-_ FAAS{ <br /> CONTACTP£RS011 <br /> }' usF� �t�'. -✓.:J/1 fl tl A-A !Filly- Pr+]nE <br /> RZO?ONAL,a0AS* f 1 --- ",°• -;'� .P, f:r i}L/t <br /> a `✓ "C�l 0C i3 PHONE <br /> OUANTRYLOST� <br /> .I_.. ... .• r f �U G.t h/Pf <br /> �. C+.Tc015cOVE14E0. rICwOCtcOVEAEb ❑� UNK'No ! <br /> .._. -- !I / Q PAEHtORY GCNTPAL ❑ SUMAFACE 40HIMANG NULSANCE cowaCNs <br /> amu- 3OI ! p] r 4 .❑ TAWrrST Q TAW REUOYAL ❑ OTHER ❑ <br /> GATE DISCT1Ap0E aEGAN _ A+FTr+CO US:O TO STOP OL't RGE <br /> (CHECK ALL THAT APPLY) <br /> V+XNCWHF CL® <br /> %tAS OCSCHA,ROE flEENSTCPYEO T...7 ` ❑ ❑ RELOYELXLymat; • ❑ AEPLAC TANK - CZZ TANK <br /> r... - ❑ A£PA1A-TANK - ❑ kEPAIAPPtrO <br /> C3Y`ES C3FYt3.m"re <br /> W - •-01I _ f ❑ CHMrGFPACCEOUaF <br /> SCAIACE cc OcasuAGE •u ^..`1..r.M•"•'off ••� •I •❑ 0,ECR <br /> TANKS OrA.YAJIPACIry ►IATEfnAA <br /> Q TANKLEAK C.WSS(S)•- _ <br /> �UNf40riN /rk'I°'"7 Qp0 AGWS <br /> .. ..- ❑ PIPWO LEW / CAL FI9E ❑ OYERF[L.• ❑ ALPTUpZFALUPc <br /> ❑ OT-ER ��-ry�'^�YRS STEEL ❑ CORROS+OH <br /> . . uw-,tn`N ❑ OTHER a SVRL ❑ OTr�ER <br /> y GwECKCnEONLY <br /> .... 3�� UhO£TFALLtNEO ❑ 561lJNLY ❑ <br /> " GOEOY GROUTIOWATER ❑ OA"'KT0WATER• cNECXONYFWATERY.ESHAVEACTUALLYaEEAAFYsT- <br /> � <br /> CD SITE NYE5T7W77CHWPRCrR£SS)CEFp1ryG EA7EM OFPAOt3LEN ❑ C.EAtitPWPROGRESS❑ S-WOOFF([LEAA,UP COUPLE-,to OR U -EC£SSARY) <br /> - ❑ IOACTJCNTAKEN CDPCSTCLEATA7vCJCwR09TOWPfpOA£S7 <br /> ❑ WFUNCSAYAUBCE'OPROC£ED ❑ EYALWTw,aCLEANIPAL?CANArn45 <br /> CHECK APPROPAIA,e ACTgNT5l fSsc'4AC+I <br /> ❑ CAP SITE)GCi ❑ FXCAYATEiOSPGSE(Eb) AEUO FRE:PAWWT <br /> • ❑ (FP) ❑ ENHANCEbaa CECRACATICN;7 . <br /> C C:.HTAft:AIENT aARRlc4)Cd} ❑ EzC-kvArEA TREAT(ET) P-.UPITAEAT6RQLlWWATER <br /> ❑ Ta EA:L+ENTATHOCKUP A-lA ❑ NO AC TION PECVIREO Itiy ❑X OIHEA IDA fGT)❑ RePI.L.E Si- <br /> •PLY)RS) <br /> ) Z0 rJ i3 L G;t riiFf s'�� r'o,/',./f/'�.:/;•/�,-• � . <br /> UE RU.UCTION OF UU5 <br /> DOCUMENr GANW9 bE <br /> � IMPROVED TUE 10 PTTE <br /> L COMITION or, THE OWGINAL <br />