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SITE HISTORY
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544601
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SITE HISTORY
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Last modified
6/25/2019 5:14:09 PM
Creation date
6/25/2019 4:35:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0544601
PE
3528
FACILITY_ID
FA0002253
FACILITY_NAME
JACK FROST ICE SERVICE
STREET_NUMBER
36
Direction
N
STREET_NAME
D
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15318028
CURRENT_STATUS
02
SITE_LOCATION
36 N D ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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S. a. Describe the tpethod that will be utilized to purge and/or inert the tank(s): <br /> ' ctu--O / <br /> -144-70 T14E M& FE [ [+f S LT c��S j'►,.=� ��5� � ��- �� u�'a�"�.[;•t'y <br /> b. Tank/Piping Hauler: <br /> Name <br /> Address �� `t v .�� _ �" City U Ip <br /> Phone No.( <br /> Hauler Registration #(if hauled as hazardous) LQI� <br /> C. Tank/Piping Disposal Site: <br /> Name A <br /> Address ti 1 ACT, u - City � j ru�ip I <br /> Phone No.c`�- ) F ' i4 <br /> EPA M#(if transported to a permitted TSD facility) 14MA i 7AI-wA <br /> 9. Describe, in detail, how the soil and/or water sample(s) beneath the tank and piping will be obtained: <br /> 10. Describe how the excavation will be backfilled with suitable material upon removal: <br /> 11. Handling of excavated soil: <br /> a) What material will be used to line the tank pit and cover the stockpile? <br /> b) What fwill be the final destination of the excavated stockpile? <br /> 1TVIrN M"�i FV7—j c-D +'H',11LI TD <br /> c) Contaminated <br /> � Soil Hazardous Waste Hauler: ��(�-;{Lp�}-•�14W.0�i L L <br /> Name f� 7T Irq-&- Hauler Registration 11.15 <br /> Address _ City r E-"7-1D e cot, Zip Qss� <br /> Phone No. 1 no <br /> EH 23 046 (Revised 9111196) Page 5 <br />
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