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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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5023
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3500 - Local Oversight Program
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PR0545537
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
3/12/2020 3:37:00 PM
Creation date
3/12/2020 2:36:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545537
PE
3528
FACILITY_ID
FA0008034
FACILITY_NAME
FRANKS TIRE SERVICE
STREET_NUMBER
5023
Direction
N
STREET_NAME
MARKET
STREET_TYPE
ST
City
LINDEN
Zip
95236
CURRENT_STATUS
02
SITE_LOCATION
5023 N MARKET ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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UNDERGROUND STORAGE TA*UNAUTHORIZED RELEASE (LEAK)/C NTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES ;FOR.LOCAL`AGENCTUSE QNLY >: <br /> REPORT BEEN FILED 7 YES ❑ NO I HEREBY CERTIFYTHAT}:HAVE DISTRIBUTEOTHIS INFORMATION ACCORDING TO THE 3 <br /> ❑ YES NO ::DISTRIBUTIONSHOWNON:7HE.WSTRUCTIONSHEETONTHEBACKPAGEOFTHISFORM:... <br /> REPORT DATE <br /> FCASE SIGHED DATE. <br /> NAME OF INDIVIDUAL FILING REPORT PHONE SIGNATURE <br /> tAl p- <br /> w REPRESENTING Q OWNER/OPERATOR PdGIONAL BOARD COMPANY OR AGENCY <br /> ZELOCAL AGENCY Q OTHERCc c`)' •c],r <br /> ADDRESS <br /> C) <br /> D SC) �QJ1J+�� '1 . �1.c' I S!!�+' ' ��� V�`�V/'- CA- <br /> CRY <br /> STATE ZIP <br /> STREET <br /> Lu NAME CONTACT PERSON PHONE <br /> Q UNKNOWN <br /> s ate- �o� 6 - 7� <br /> a a <br /> `ta ADDRESS <br /> -&A-:2- �J ' t n� <S+Q,,c, k� 9 <br /> c4 vaa <br /> FACILITY NAME(IF APPLICABLE) OPERATOR PHONE <br /> l� /`rL� c <br /> s ADDRESS- / 36 <br /> O a 3 1VL r Q rREEr ccP <br /> cRoss STREET � lO <br /> OLOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> Lu <br /> w w REGIONAL BOARD U <br /> /PHONE <br /> 1 <br /> w (�) <br /> W $� NAME QUANTITY LOST GALLONS) <br /> UNKNOWN T73 E <br /> OWNH V <br /> m z <br /> N- ❑ UNKNOWN <br /> f- DATE DISCOVERED HOW DISCOVERED ❑ INVENTORY CONTROL ❑ SUBSURFACE MONITORING ❑ NUISANCE CONDITIOIJIS <br /> z /) <br /> w JMI / �D Y ❑ TANK TEST TANK REMOVAL OTHER <br /> a <br /> m DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPL <br /> UNKNOWN REMOVE CONTENTS CLOSE TANK&REMOVE ❑REPAIR PIPING <br /> w M D Y T"\ <br /> HAS DISCHARGE BEEN STOPPED T ` Q� QV Q Y ❑REPAIR TANK ❑CLOSE TANK S FILL IN PLACE ❑CHANGE PROCEDURE <br /> `2 YES ❑ NO IF YES,DATE / / 4 J C� Q REPLACE TANK O OTHER (� <br /> MI \V <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> w <br /> TANK LEAK ❑ UNKNOWN ❑ OVERFILL ❑ RUPTUREIFAILURE a SPILL <br /> oQ V ❑ PIPING LEAK ❑ OTHER CORROSION F-1 <br /> UNKNOWN a OTHER <br /> w awl CHECK ONE ONLY r(' <br /> U Q UNDETERMINED SOIL ONLY ❑ GROUNDWATER ❑ DRINKING WATER -(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) v� <br /> CHECK ONE ONLY <br /> w �NO ACTION TAKEN F7 PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED ❑ POLLUTION CHARACTERIZATION <br /> w Q LEAK BEING CONFIRMED a PRELIMINARY SITE ASSESSMENT UNDERWAY ❑ POST CLEANUP MONITORING W PROGRESS <br /> y <br /> V ❑ REMEDIATION PLAN ❑ CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY <br /> CHECK APPROPRIATE ACTION(S) EXCAVATE E DISPOSE(ED) Q REMOVE FREE PRODUCT(FP) ❑ ENHANCED BIODEGRADATION(IT) <br /> V*E ell=FOR DOOM <br /> J ❑ <br /> So CAP SITE(CD) EXCAVATE 6 TREAT(ET) Q PUMP 6 TREAT GROUNDWATER(GT)❑ REPLACE SUPPLY(RS) <br /> Z <br /> Lu a ❑ CONTAINMENT BARRIER(CB) ❑ NO ACTION REQUIRED(NA) ❑ TREATMENT AT HOOKUP ❑ VENT SOIL(VS) <br /> 2 ❑ VACUUM EXTRACT(VE) OTHER(OT) L? <br /> z <br /> cow <br /> co <br /> HSC 05(Wo /. <br />
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