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COMPLIANCE INFO 2017 - 2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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2300 - Underground Storage Tank Program
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PR0231760
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COMPLIANCE INFO 2017 - 2018
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Last modified
8/21/2019 11:07:05 AM
Creation date
8/21/2019 9:40:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017 - 2018
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
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 X NO [ ] <br />b. Identify contractor performing decontamination: <br />Name Eiite IV Contractors Phone (209) 461-6: <br />Address ?53�wam Dr City Stockton Zip <br />c. Describe method to be used for decontamination: <br />Triple Rinse <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />Will dispose material in dumpster <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: / <br />Hauler Name American Valley Waste oil Phone ( 800) 732-4645 Ha er Reg# 3744 <br />Address PO Box 340 City D i Zip 95315 <br />Permitted Disposal Site SteriCycle - <br />- 2095 Newland, N 49V 88 08 CIEPA Ned 98089: <br />6. a. Describe the method that will be utilized to purge and/or inert the <br />[: <br />Piping Hauler: <br />Name <br />Address <br />Hauler Registration # (if hauled as hazardous <br />Phone ( ) <br />City Zip <br />c. Piping Disposal Site: <br />Name Waterloo Shell Phone (209 ) 931-3674 <br />Address 4315 E Waterloo Rd City Stockton Zip 95205 <br />EPA ID# (if transported to a permitted TSD facility) <br />7. Is the sampling firm an independent third party from the contractor? YES N NO [ ] <br />a. Identify sampling firm: <br />Name Advanced Gel Environmental, Inc Phone( 209) 467-1006 <br />Address Q37 chawRd City Stockton Zip 95215 <br />b. Identify laboratory performing analysis: <br />Name EnviroChem Phone ( 909) 590-5905 <br />Address 1214 E Lexington Avenue City Pomona Zip 91766 <br />8. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br />Discrete samples will be collected using a metric soil sampler and clean, stainless steel sleeves. <br />Samples will be collected direstly beneath UDCs and/or from the backhoe bucket <br />9. a. Handling of a avated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name American Valley Waste Oil Hauler Registration # 3744 Phone (800)__L32-4645 <br />Address 0 Box 340 City Delhi Zip 95315 <br />b. If soil 's not to be hauled, describe what will be done with it: <br />Foil is non -contaminated, it will be spread on-site. Q P r_ � 1N r <br />.7 %_ - - <br />�0.w <br />EH230038 (revised 12-11-15) 4 <br />APR 1�g2018 <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />
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