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UST Case Closure Summary Form <br /> Agency Information <br /> Agency Name: San Joaquin County Environmental Address: 1868 East Hazelton Avenue <br /> Health Department <br /> City/State/Zip: Stockton, California 95205 Phone: (209) 468-9852 <br /> Staff Person: Victoria McCartney Title: Senior REHS <br /> Case Information: (expand if needed) <br /> Facility Name: Country Market <br /> Facility Address: 10476 West Linne Road, Tracy, California 95376 <br /> RB LUSTIS Case No: 391189 Local Case No.: 0002070 LOP Case No.: 0002070 <br /> URF Filing Date: 03/17/2015 Global ID: T10000004612 <br /> Responsible Party(s): Address: Phone: <br /> John Muniz, Jr. 11931 Mountain View Road (209) 992-6740 <br /> Tracy, California 95376 <br /> Saleh and Elizabeth Ann 1627 East Anderson Street <br /> Eltareb Stockton, California 95205 <br /> Tank Information (Delete table if Tank info becomes a tab in GeoTracker and included in CSM Report) <br /> Tank No. Size(gal) Contents Closed in-Place/ Date <br /> Removed/Active <br /> 39-000231656-0164301 350 Regular Unleaded Removed 11/16/2012 <br /> 39-000231656-0164302 500 Premium Unleaded Removed 11/16/2012 <br /> Conceptual Site Model (Groundwater from an onsite domestic well and soil data included; <br /> "Revised Site Investigation Report & Case Closure Request", dated 6 February 2015, <br /> replaces the CSM Report. <br /> Closure Criteria Met (GeoTracker LTCP Checklist included) <br /> Optional Site map(s) (Not applicable) <br /> https://geotracker.waterboa rds.ca.gov/regulators/esi/reg u lators.asp?cmd=viewsite&glob <br /> al id=T10000004612 <br /> 2014-2015—LOP Agency Guidebook-Section 9 <br />