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COMPLIANCE INFO_2001-2005
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231866
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COMPLIANCE INFO_2001-2005
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Last modified
6/10/2020 12:59:43 PM
Creation date
6/3/2020 9:53:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2005
RECORD_ID
PR0231866
PE
2361
FACILITY_ID
FA0003957
FACILITY_NAME
AT&T California - UE020
STREET_NUMBER
124
Direction
W
STREET_NAME
ELM
STREET_TYPE
St
City
Lodi
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
124 W Elm St
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231866_124 W ELM_2001-2005.tif
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EHD - Public
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Oct 25 01 11 : 22a TAIT Environmental System (916) 858-1011 p. 15 <br /> n. GENERAL INFORMATION: <br /> 1. Obtain an EPA Site Number from the Department of Toxic Substances Control(800)61-TOXIC for temporary <br /> hazardous waste removal activitles associated with underground storage tank(UST)removals. <br /> 2. Disposal Information: Public Health Services Underground Storage Tank Disposition Tracking Record(UST <br /> Tracking Record, page 10)shall accompany each tank removed from:site. Tank(s)will be issued an identification <br /> number which PHS-EHD°s representative will note on the UST Tracking Record. Contractor will affix same <br /> identification numrber onto tank end using fluorescent spray paint. Contaminated tanks and/or piping are to be <br /> transported under Hazardous Waste Manifest by a state registered hazardous waste hauler. <br /> 3. Contractor to Provide: Combustible/Flammable gas detector(to verify the Lower Explosive Limit(LEL) <br /> atmosphere and oxygen level of tank prior to lifting from excavation), adequate numbers)and appropriate type(s)of <br /> fine extinguisher(s), barriers to secure the area as necessary to minimize traffic and pedestrian interference,and <br /> fluorescent spray paint to affix tank identification numbers. It shall be the project manager's responsibility for <br /> compliance with all health dd safety regulations and requirements,which shall be strictly adhered to at all times <br /> during the course of the closure activities. <br /> 4 The PHS-EHD permit shall be on site during tank excavation and removal. <br /> S. Any changes in this document shall be approved by PHS-EHD prior to initiating work. <br /> 6. Closure-in-Place: If Closure-in-Place is the suggested method of abandonment,complete form <br /> EH 23 039 and submit written approval from the local Fire Department. <br /> 7. Temporary Closure: If Temporary Closure is the suggested method of abandonment,complete <br /> ' and submit this form and a written approval from the local Fire Department. <br /> a. The following documentation shall be submitted within 30 days of the tank removal date: <br /> a) Analytical results,nulled directly from laboratory to PHS-EHD,including a chain of custody and quality <br /> assurance and quality control(QA Sx QC). <br /> b) UST Tracking Record Sheets)and/or Tank Hazardous Waste Manifest(s). <br /> C) Tank Closure Certification Form(DISC form 1249). <br /> d) Hazardous Waste Manifests for Piping,rinsate,residual fuel,or waste oil receipt. <br /> e) Submit the backfill excavation certificate as required by San joaquin Courcy and the incorporated City <br /> Building Departments. This report will be referred to the appropriate agency for their review. <br /> A site which bas bad UST(s)removed,shall not be considered for final closure until the above items are <br /> submitted for review. <br /> III. SITE MITIGATION: <br /> 1. In the event contamination is observed,confirmed or suspected as a result of a leaking UST system it is the <br /> responsibility of the owner or operator to submit a work plan to PHS-EHD Site Mitigation Unit and have it approved <br /> prior to initiating any assessment or remediation activities. To minimize delays,the work plan may be submitted <br /> concurrent with tank closure or installation plans. Address one copy of the work plan to the Site Mitigation Unit for <br /> review. If the site is roc currently in the Local Oversight Program, a billing form and a$261 minimum fee must be <br /> submitted with the work plan. For further assistance contact the Site Mitigation Unit at(209)468-3450. <br /> EH 23 046 (Revised 09/21/00) Page 2 <br /> 10/25/01 THU 10:14 [TX/RX NO 87481 @015 <br />
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