Laserfiche WebLink
i <br /> k Lor <br /> UNDERGROUND STORAGE T and UNAUTHORIZED RELEASE(LEAK)/O,.�TAMINATION SITE REPORT <br /> EMERGENCY <br /> HAS STATE OFFICE EMERGENCY SERVICES FOA LOCAL- <br /> REPORT <br /> OCAt AGENCY USE ONLY <br /> ❑YES REPORT BEEN FLED 7 ❑YES ❑ NO DLSiAI�)T10N SHOWN�d".THE NISTRUCT)ON(StET.ONBAf,K PAGE FOR <br /> REPORT DATE CASE s i <br /> 7 1 d 9 976 <br /> a <br /> NAME OF INDIVDUAL FtiNIG REPORT PHONE S TU E <br /> JERRY YOSHIOKA (2 9) - <br /> C REPRESENTING ❑ py�R/OPERATOR ❑ REGIONAL BOARD COMPANY Oa <br /> S <br /> ® LocuAGENCY ❑ OTHER SAN �oro COUNTY ENVIRONMENTAL HEALTH <br /> � <br /> ADDRESS <br /> 304 E. WEBER � CITYSTOCRTON STATE CA 9 O1 <br /> CONTACT PERSON PHONE <br /> ,y NAME ( 1 <br /> N P ❑UNKNOWN i <br /> a ADDRESS TRACY CA 95376 <br /> s 7777 W. ELEVENTH STREET STAB ZIP <br /> crry <br /> FACILITY NAME(IF APPLICABLE) OPERATOR <br /> sTpeff PHONE <br /> 6 QNrP LUMBER <br /> tj O ADDRESS <br /> s CIT, SA%,,7r0A UIN <br /> w <br /> H CROSS STREET <br /> CHRISMAN ROAD <br /> LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> SAN JOA UIN CO. ENVIRONMENTAL H TH JERRY YOSHIOKA 9 � 4 $- 335 <br /> Lu <br /> w� REGIONAL BOARD PHONE <br /> RL l 1 <br /> NAME <br /> QUANTTTY LOST(GALLONS) <br /> ut J7 LiGAS'OLIKE UNKNOWN <br /> OWN FUEL lnvKNOWN <br /> VERED HOW DISCOVERED ❑ INVENTORY CONTROL ❑ SUBSURFACE MONITORING ❑ NUISANCE CONDITIONS <br /> _ ❑ OTHER <br /> 91 w TANK TEST TANK REMOVAL <br /> w <br /> 7 1 90 9 <br /> < DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> < ® UNKNOWN REMOVE CONTENTS ®CLOSE TANK&REMOVE ❑REPAIR PIPING <br /> cci <br /> o HAS DISCHARGE BEEN STOPPED 4 ❑REPAIR TANK F-1CLOSETANK i F!L W PLACE ❑CHANGE PROCEDURE <br /> �YES ❑ NO IF YES,DATE 7 J V y ❑REPLACE TANK E]OTHER <br /> 0 <br /> TL <br /> URCE OF DIRGE <br /> CAUSE(S) <br /> ® TANK LEAK ®�UNKNOWN ❑ OVERFILL ❑ RUPTURElFAILURE ❑ SPILL <br /> PIPING LEAK ❑ OTHERCORROSIONtNNIQNOWN ❑ OTINEA <br /> ECK ONE ONLY <br /> ® UNDETERMINED ❑ SOIL ONLY ❑ GROUNDWATER ❑ DRINKING WATER-(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> =ai ❑ NO ACTION TAKEN ❑ PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED ❑ POLLUTION CHARACTERIZATION <br /> cc <br /> ® LEAK BEING CONFIRMED ❑ PRELIMINARY SITE ASSESSMENT UNDERWAY ❑ POST CLEANUP MONITORING IN PROGRESS <br /> U ❑ CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY <br /> REMEDIATION PLAN ❑ <br /> CHECK APPROPRIATE ACTION(S) ❑ EXCAVATE&DISPOSE(ED) ❑ REMOVE FREE PRODUCT(FP) ❑ ENHANCED BIO DEGRADATION(1T) eC <br /> tall ria►ar l 7� <br /> 16 cc <br /> ❑ CAP SITE(co)(CD) ❑ EXCAVATE 6 TREAT(ET) ❑ PUMPS TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY{RS) V+1T- <br /> w< ❑ CONTAINMENT BARRIER(CB) ❑ ND ACTS REQUIRED(NA) ❑ TREATMENT AT HOOKUP(Hll) ❑ VENT SOIL(VS) <br /> ❑ VACUUM EXTRACT(VE) ❑ OTHER(OT) <br /> rn <br /> z <br /> z <br /> w <br /> HSC 05 larval <br />