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<br /> h.r& faf f.eciesosR.7n, of conta.nnants.
<br /> Stor nar,.:n of r.h., ' .M1 :n;; ay nd Roo on 1 "t r TO iV C_wtr-ol Nard,. Replace Su(.. y _ provide alterfrative water supply to affected
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<br /> No Action Rewired a inciArnt is Eninoo mpiring no
<br /> p £. ed Fen, iearr€i;zLkn on, No suistonces ifappropriate. f. nv rt than two rcrodil= 50010-7--
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<br /> suDatanc 1pak.�c, list the two of Moat'£atrn r;n for cleanup, - CMEUTS - Use this space to 00"as .,n ar€v aspects of tt,e ;ncHeot.
<br /> SCOVEiltl`iF r t NT Sr Pft 1 T Sin tine form in Be sl. e provided.
<br /> >.,.arding the; discovery annci aha5=0 of div leak., &MMMUTIOR
<br /> S'DUR E,AAUSS ' If the form is cmpletod by the tank owner or has agent, retain the last copy
<br /> of leak. Provide details or, rank age; capacity and anon forward the rernaninin, copies in tact to your.local sankperirittinq agency
<br /> atarial if known. ��eCk ;3;> ,r ;n indicating cause of lent, for distribution.
<br /> I, Original - Local Tank Fe mittir�€, Agency
<br /> CASE TYPE < 2. State, Water~ Resources Control Board, Division of Water Quality,
<br /> Ir.or af_ the case tyov con-g=ry fur this leak. Speck ow pox on'l" `"ase tylia
<br /> Underground yank 6rv�s�ra.9, P. C. Box I001, Sacrar,ente, CA 95801
<br /> is based on the most sensitive resource, aff€cterl. For exar.;ple, if both Soil 3, Regional Water Quality Control Soard
<br /> ad ti "d w;a e, h"e Isom a4f"ted, Masi: type will he "Ground Water". 4, County Board o; Supervisors or designee. to receive Proposition 65
<br /> Jodi 'Drinking Water curly if one it inore municipal or dtanestic water notifications.
<br /> ,qcl is tn)va� r.£ tually ?awn afis.Yth A ` " d �<.�r desi7ation bores neat � 6 a er�Lrnsponsidle arty,
<br /> iraliiy Bat the affected water cannot be, or is not, used for drinking water,
<br /> but ly that water wells have net of bun affected- It-0 understood that
<br /> case type maty ciian,v upon further investigation.
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