My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
L
>
LINCOLN
>
203
>
3500 - Local Oversight Program
>
PR0545378
>
SITE INFORMATION AND CORRESPONDENCE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
2/13/2020 5:57:47 PM
Creation date
2/13/2020 3:44:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545378
PE
3528
FACILITY_ID
FA0006112
FACILITY_NAME
EDWARD PITTS
STREET_NUMBER
203
Direction
S
STREET_NAME
LINCOLN
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
203 S LINCOLN AVE
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
92
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
16 <br /> UNDERGROUND STORALt TANK UNAUTHORIZED RELEASE(LEARr/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES FOR.LOCAL AGENCY USE ONLY:.,• <br /> REPORT BEEN FILED 7 <br /> ❑ YES No ❑y ,T HEREBY C"RT1EY?HAT},:HAVE DtiSTR18UTED:?}itS INfCRb1AT10NACt�RDING TO THE ...::... <br /> OtMISUTIONSHMONTHE.wsmCnON ONIHESACKPAGE <br /> REPORT DATE CASE a. OfTHISrORAI: : <br /> �I wl d d Cl rI Sr3XE[3 ,. . oATE <br /> m NAME OF INDIVIDUAL FILING REPORT I PHONE SIGNATURE <br /> `f6 <br /> w REPRESENTING ❑ OWNERWERAT'OR ❑ REGIONAL BCARD COMPANY OR AGENdY NAME <br /> aOCAL AGENCY ❑ OTHER <br /> Lu ADDRESScrry <br /> w NAME CONTACT PERSON G AAtE� ZIP <br /> Z CC CX r �` �\ UNKNOWN PHONE <br /> CC ( ) <br /> O< ADDRESS <br /> as <br /> Zo3 s L�,c o C, A C aj LATEzrp <br /> FACILITY NAME(IF APPLICABLE) OPERATOR PHONE <br /> o Q i'I`O ( } <br /> < ADDRESS <br /> W -e ,�� o/.� arr, <br /> y CROSS STREET P <br /> z LOCAL AGENCY AGENCY NAME I CONTACT PERSON <br /> y PHONE <br /> `=w ( ) <br /> W <br /> CL< REGK)NAl30AAD n I PHONE <br /> y (II NAME OUANTITY LOST(GALLONS) <br /> Lu <br /> <J UNKNOWN <br /> m OI (2) <br /> ❑ UNKNOWN <br /> z ( DATE DISCOVERED HOW DISCOVERED ❑ INVENTORY CONTROL ❑ SUBSURFACE MONITORING ❑ NUISANCE CONDITIONSLu <br /> 1 <br /> w G ❑ HERJ3yl <br /> r- <br /> < DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) (" <br /> a - <br /> 41 c t U M"" N [:]REMOVE CONTENTS CSE TANK E REMOVE ❑REPAIR PIPING <br /> Lu <br /> U HAS DISCHARGE BEEN STOPPED Z ❑REPAIR TANK ❑CLOSE TANK b FILL IN PLACE ❑CHANGE PROCEDURE <br /> Ln ES ❑ NO IF YES DATE /M{ Q� D r� r ❑REPLACE TANK ❑OTHER <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> U w <br /> a L ' ANK LEAK ❑ UNKNOWN ❑ OVERFILL ❑ RUPTURE/FAILURE ❑ SPILL <br /> h v ❑ PIPING LEAK ❑ OTHER ❑ CORROSION �V 1MOWN ❑ OTHER <br /> Lu w CHECK ONE ONLY <br /> ha <br /> NOETERMINED ❑ SO4 ONLY ❑ GROUNDWATER ❑ DRINKING WATER-(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ON Y <br /> w NO ACTION TAKEN r7 PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED F7 POLLUTION CHARACTERIZATION <br /> w ❑ LEAK BEING CONFIRMED ❑ PRELIMINARY SITE ASSESSMENT UNOERWAY ❑ POST CLEANUP MONITORING IN PROGRESS <br /> U I ❑ REMEDIATION PIAN ❑ CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION(S) <br /> r�esu son aero ❑ EXCAVATE&DISPOSE(EDI ❑ REMOVE FREE PRODUCT(FP) ❑ ENHANCED BIO DEGRADATION(In <br /> � a <br /> ). <br /> co ❑ CAP SITE(CO) ❑ EXCAVATE d TREAT VIM ❑ PUMP 3 TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY(RS) <br /> Lu <br /> < ❑ CONTAINMENT BARRIER(C3) ❑ NO ACTION AEOUIRED MW ❑ TREATMENT AT HOOKUP(HU) ❑ VENT SOIL(VS) <br /> ❑ VACUUM EXTRACT(VE) ❑ OTHER(01) d <br /> cn <br /> F✓i �� s i'1 -- .l�I w�S 7i`fc a Trow ,`ll ybG /ICcCS Spry <br /> z / <br /> 1 v • <br /> - { Hsc os le+sat i - <br />
The URL can be used to link to this page
Your browser does not support the video tag.