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e UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK)/ CONTAMINATION SITE REPORT EMERGENCY HAS STATE OFFICE OF CMERGkNCY SERVICES FOR LAI,AGEP REPORT BEEN FILED" I HEREBY CERTIFY THAT I HAVE'DISTRIBUTI, HIS INFORMATION ACCORDING TO THE ❑YES ®NO DISTRIBUTION SHOWN ON THE INSTRUCTION SMEET ON THE BACK PAGE OF THIS FORM ❑YES ®NO REPORT DATE CASC u 1 0 0 4 0 6 U M p n Y YPHONE S GNATURI- NAME OF INDIVIDUAL FILING REPORT '' Ruth Ha 503 5246191 [:]LOCAL ®OWNERrOPCRATOR ❑ REGIONAL BOARD COMPANY OR AGENCY NAME o C]LOCAL AGENCY OTHER - BP Wast Coast Products LLC ADDRESS Palma CA 90623 La 4 Centerpointe Drive La aSTATE ZIP STREET PHONE NAME CONTACT PERSON 7 BP West Coast Products LLC ❑UNKNOWN Ruth Iia 503624-6191 d ADD Bs a GA 90623 h iSTATE ZIP 4 Centerpointe Drive La Palma rr STREET CITY FACILITY NAME(IF APPLICABLE) OPERATOR PHONE [2 Arco Facility No.02093 209 835-1605 Q ADDRESS Lodi Sean Joaquin 95240 0 3425 Tracy Blvd. Lo COUNTY ZIP 2µI STREET y CROSS STREET Clover/TraC PHONE FREG—IONA—LBOARD AL AGBNCY AGENCY NAME CONTACT PERSON Coun of San Joa uin/Environmental Health Division Dou Wilson 2Oa-468-3446 NE r 916-255-3000 Central Valley Regional 1Rlater Quality Control Board 5 QUANTITY LOST(GALLONS) y 11} NAME w o 3 JZ UNKNOWN Gasoline m (Z) _ ❑ UNKNOWN qI r� DATE OISCOVEREO HOW DISCOVERED ❑ INVENTORY CONTROL ❑:;UBSURFACE MONITORING NUISANCE CONDITIONS i 1 0 0 3 0 6 ❑TANK TEST ❑TANK REMOVAL ® OTHER DaSlgnated OparaW INep8=n aDATE DISCHARGE BEGAN Y Y METHOD USED 1'O STOP DISCHARGE(CHEEK ALL THAT APPLY) 1 0 0 3 0 6 ®UNKNOWN ❑ REMOVE C(-NTENTS ❑CLOSE TANKS REMOVE © REPAIR PIPING M M p p V Y HAS DISCHARGE BEEN STOPPED? ❑ REPAIR TANK ❑CLOSE TANK&FILL IN PLACE CHANGE PROCEDURE G2 1 0 0 3 0 6 ❑REPLACE TANK ® OTHER Shut di.pnnsar down NO ®YES ❑NO IF YES,DATE M M III DI Y Y SOURCE OF DISCHARGE CAUS (S) U TANK LEAK ❑ UNKNOWN ❑ OVERFILL RUPTUREtFAILUR£ ❑ SPILL �_ ❑ o PIPING LEAK [� OTHER CORROSION OTHER UNKNOWN ❑ m CHECK ONLY ONE ❑ UNDETERMINED ❑ SOIL ONLY ❑ GROUNDWATER ❑ DRINKING WATER-(CHICK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) CHECK ONLY ONE ❑ NO ACTION TAKEN ❑ PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED POLLUTION CHARACTERIZATION M j6 ❑ LEAK BEING CONFIRMED ❑ PRELIMINARY SITE ASSESSMENT UNDERWAY © POST CLEANUP MONITORING IN PROGRESS U h ❑ REMEDIATION PLAN 13 CASE CLOSED(CLEANUP COMPLETED OR UNNECESSARY) ❑ CLEANUP UNDERWAY CHECK APPROPRIATE ACTION(S) ❑ EXCAVATE&DISPOSE(ED) ❑ REMOVE FREE PRODUCT tFP) ❑ ENHANCED&10 DEGRADATION(IT) 1iEE P^CKrOIt OETNkSI REPLACE SUPPLY RS c Q ❑ CAP SITE(GD) ❑ EXCAVATE&TREAT(ET) ❑ PUMP&TREAT(SROUNDWATER(GR) ❑ IRS) w r VENT SOIL(VS) Q ❑ CONTAINMENT BARRIER(C8) ® NO ACTION REQUIRED(NA) ❑ TREATMENT AT HOOKUP(HU) $ ❑ VACUUM EXTRACTIVE) ❑ OTHER During routine designated operator inspection found approximately 3 gallons of gasoline 87 products in the UDC. y Contractor went to site Pumped out all liquid and put dispenser out of order. Will return and repair piping. All product was, contained in the UDC.