Laserfiche WebLink
N <br /> UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE(LEAK)/CONTAMINATION SITE REPORT <br /> EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES <br /> REPORT BEEN FILED ttr~.....C1HAVE R�pTfDTHiS MATiACt�6it)INfaTOT#(E <br /> ED YES []a NO ❑YESNO <br /> tf�N � C�' �DtE P OFTW <br /> CASE i <br /> REPORT DATE 5 <br /> 0 3M 2 9 4 slcnEv, LiATE <br /> NAME OF'INDIVIDUAL'FILING REPO <br /> RT PHONE S <br /> C. Susi Jackson (510 } 423-6577 <br /> REPRESENTING M OWNERtQPERATOR ❑ REGIONAL BOARD COMPANY OR AGENCY NAME <br /> ® LOCAL AGENCY [� OTHER University of California <br /> ¢ ADDRESS <br /> P.O. Box 808, L-633 7000 East Avenue Livermore CA 94550 <br /> CITY STATE ZIP <br /> W NAME CONTACT PERSON PHONE <br /> g Dennis K. Fisher ❑UNKNOWN C. Susi Jackson ( 510) 423-6577 <br /> ADDRESS <br /> CL <br /> P.O. Box 808, L-6 68 STREET 7000 East Avenue C�Livermore SAE 945P50 <br /> PHONE <br /> Lawrence Livermore N <br /> FACILITY NAME(IFF APPLICABLE) OPERATOR ational Laboratory <br /> Site 300 Buildia -836 Dennis K. Fisher (510 )422-3343 <br /> a ADDRESS <br /> Corral Hollow Road South of Tracy San JoaquinSTPM C" P <br /> CROSS STREET <br /> Interstate 580 <br /> LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE <br /> w San Joaquin Count Public Health Servic s William Snavely ( 209)468-0336 <br /> 2 REGIONAL BOARD PHONE <br /> Uj <br /> Central Valley RWQCB Susan Timm ( 916) 255-3057 <br /> p0 NAME QUANTITY LOST(GALLONS) <br /> Ow Diesel Fuel UNKNOWN <br /> (2) <br /> 0 UNKNOWN <br /> r� DATE DL�OVERED, HOW DISCOVERED INVENTORY CONTROL. ® SUBSURFACE MONITORING F--j NUISANCE CONDITIONS <br /> Q 1 8 0 9 4 y ❑ TANK TEST TANK REMOVAL ® OTHER� '�n <br /> � �f Sample Ana]yses <br /> 4 DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE(CHECK ALL THAT APPLY) <br /> ® UNKNOWN ®REMOVE CONTENTS CLOSE TANK&REMOVE ®REPAIR PIPING <br /> HAS DISCHARGE BEEN STOPPED? ®REPAIR TANK CLOSE TANK S FIX:{.IN PUKE Q CHANGE PROCEDURE <br /> o Eil YES ® NO IFVES.DATE Q 3 1 .11 9 ,14 r ❑REPLACE TANK ❑OTHER <br /> SOURCE OF DISCHARGE CAUSE(S) <br /> ®`TANK LEAK Q UNKNOWN ED OVERFILL Q RUPTURE/FAILURE SPILL <br /> PIPNGLFAK OTHER ® CORROSION ® UN ® OTHER <br /> cUA 3 W CHECK ONE ONLY <br /> E] UNDETERMINED ® SOIL ONLY GROUNDWATER [:] DRINKING WATER-(CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) <br /> CHECK ONE ONLY <br /> W <br /> No ACTION TAKEN ❑ PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED POLLUTION CHARACTERIZATION <br /> s a ® LEAK BEING CONFIRMED ® PRELIMINARY SITE ASSESSMENT UNDERWAY ® POST CLEANUP MONITORING IN PROGRESS <br /> y E] REMEDIATION PLAN ® CASE CLOSED rLEANUP COMPLETED OR UNNECESSARY) ® CLEANUP LWDERWAY <br /> CHECK APPROPRIATE ACTION(S) ❑ EXCAVATE&DISPOSE(ED} REM FREE PRODUCT(FP} ® EN ED BIO DEGRADATION(RTD <br /> a"t PUMP&TREAT GROUNDWATER(GT) REPLACE SUPPLY(RS) <br /> CAP SITE(CO) EXCAVATE&TREAT(ET) <br /> W Q ® CONTAINMENT SARRIER(CB) NO ACTION REOUIRED(NA)' TREATMENT AT HOOKUP(HU) ED VENT mil(VS) <br /> Q 'VACUUM EXTRACT(VE) OTHER(OT) Remove' tank & overexcavate <br /> Sensory evidence suggested dispersed contamination in the bottom of the excavation. <br /> Suspected impacted soil was excavated and sampled. Tank testing had shown this tank <br /> for be leak tight. <br /> ►SC 05(S" <br />