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F?vL`i 1 __...,. L ak fr ?""sf s;,ccl - beak si pected at sjiltebuthas net "a.Feeaz;rc rs ..r1 aa,-'
<br /> indicate whether -
<br /> Uez y rperzµc l _.=.tney aha eza, cre be.. , r _is.M ztr ssn ri a nr'ar vb. r, apr,r<z
<br /> at arz , tKe. _f, so a-lasardous 0°zi,w r_al inc.z<e>nt Repowt s2i :z.l b f ue 3 ti , -
<br /> r d requested Is,z.a ata, x responsible > r } o date, saa>'w...t e x ui
<br /> with the K ,c office o, I:;zea, rzcva_vau.._:> (DES) at 2 D0 Meadow' _,r Ecad, is ,,�eaa, r ,,al_t impacted a. � ulu c t,e -�1 .7e-,
<br /> z_o ianent_;, 'CA 95832, gkpias of the ClS report Sorin Say be Obtained a � a�s. �ary Site t urnv ' "� � r
<br /> ctcr>rav �.e ._ta, n ,� o kp gn
<br /> your local. az: e <t, uzd storage tank lc to,, .cy, ria _ whether_ Pall-,,,tion C,c,,;_ i,. _ respo-nsible partyis in c nrocess Of fully
<br /> e ON reporshas been mss!.-ed as vl,tl.e n e ofoh3s gynct,: oei..zar1£> ,?z_-InI<t, e. c.n amina ion in coil and around water az�d rise s ng
<br /> n., n a.is or ,.trfacz and/or ground water,
<br /> ,
<br /> AGENCY O.L-.°
<br /> . R redm r * Plan "e _ai ioza �
<br /> c .laa � long, -s r
<br /> no -riIcawioz pur zant ,o 161,5tt an = afet ca --Scot,--n proposal c e
<br /> -
<br /> 25180,5 a.gcraorrl�4ent e*ldyee shmid sig and--date the form in WE block. remediation opt.orm also subiait°aed,
<br /> xzci ure he _`dors not mean thdt`the Jea, hai been determined , posy a Cr.e_.nii d rwav in>le,;rz.t<zti. of ums;.;u on lvl.aza
<br /> a,
<br /> ss mficart treat to l�u[�zat tze Itb or uaic y, 6s,ly that iotvaf cat;a?" Pr�raszr t1 xzat, r -E ?r x periodic g.ro d ..<tez, o.. b.x,
<br /> procedures `tea:,_ been `otlA ed if rareuire'. rrg -verify and/or evaluate eff4stiveneasY „o
<br /> e .r �hedzal acts x ^es
<br /> N ' C F`E fi - ase Close'i -
<br /> rep
<br /> ona,_ ,ward-az and local ag�.. in concurrence thatxaa`a
<br /> Enter eau_ name, teldplacte number,, .itsu e mow,; ;lndac rte wa ch party ��, _u<tfzer; work is necessary at, the site,
<br /> rates st and r z r� de• company or ,a{c .cy w.` � `
<br /> OS ANT: ME T,tvFMna1t� `:#. N PROVIDED ON FC�s a is INTE'DID FOR GFNck -
<br /> LA
<br /> V--s CQN57r3LEi r""?���YS�;�` IS � CSI a �.'n'i,X' AND IS P{ r p z35 F a yq
<br /> � <E
<br /> ._ 33 tt n
<br /> Exito r2 a., firl zone p r ei, cn F#r _x.sott, ?zatl adctM s s£ t,i ar* - ,:a`�CIAT F.>.`._£�1CN,tF ANY GOV RN[l.,?AM vlzd Y
<br /> ,esponuihle for the leak.- The r�z poms_.ele part3 %touad`' or aly be the t zj
<br /> a a to which a, „on have b"n�`used .e
<br /> c„ anup ofremediate ' leak,
<br /> STTE 3.NOT �,� l;Descriptions of options follow.
<br /> Enter nforraatiocn: regarding the tank facility.'- A; a zratxir.z uzn, you .r.,.st
<br /> F,rov°idez the facility ty name and full address,, Can Site - OMNI horizontal imjm,,s.=uo able lay8x o, reduce rrinfall-
<br /> IP0a 113Cents aNr install
<br /> vertical dx�,e to block horizontal' t„qvcsnent if
<br /> Enter names of the locai age,_.,, arra Regional Wats, ”` Board, -
<br /> �Eea E zt, �"�r.q_.col E,�az°� s aax s
<br /> involved, Excavate 1ax.z remove .ort;a"°-_na.,eu -Aland d.i.slAsc in- -1`...,od
<br /> t b, site, 1
<br /> JE Tla INVOLVEt) - Excavaona1, neat rtmc)e con u.nated uooil an< treat (.incluidea .pr. eat
<br /> Enter the Lanz _
<br /> apd W .t."y!At of the haza a._;xs all..7 lmv =raeolved< c7pm or land farming)
<br /> r_
<br /> s provided £ z oz a ioa on tivto u ?� W sir w rx ,f>l ut3r>afie, If :.dr _ , l_e, nr . „ .
<br /> two so bstantes lsraked, lint the two of most i%lcarn for clomp, Pump and, G 7..f rzzt: s - ,ene'ra y , i s _ouce,. this; ead
<br /> y
<br /> C or,trr hi an ts
<br /> L,a,Ci..l ERY A'-'A Tt ._ 'r>.`� t :_.:.ona as, of a.r., a"VabLe
<br /> tc c a arsr.,,;- to pt oraa,r
<br /> _
<br /> 'Provide _r> a �� on re _dfxa the dimovem and at-,atemer,L of the _ tax, _.ctWs _.c o po„x., ov of to_.t o_ a
<br /> e CY
<br /> 1 providealthrnlWe watery to s ec c portions.
<br /> _
<br /> o =r `Y o's.; tnet i wa.-., r treatmenu davices a1z east dwe litr ,
<br /> Indican atmsource(s) of r"akCheck box(nsT _,.:..a.a as cause .of leak. er t
<br /> L T'lz F, _ o - z u,
<br /> rt z xl_c n rat,
<br /> r
<br /> lz_r1:1 cat>T tha, chi L",.categary for, tol s lea, C ack one hcrr only, "casfa, No A t"z c2Mqj�F - incident 4 c nor, requiring no remedlal a An.
<br /> typx. >..s
<br /> 'based on an r. ,s, ._,.°a.,. ,_re _©,>cstzrc,a f,`a.ec;C,ed, ?'c>rrztar..l,w if
<br /> a
<br /> both sailand granirel waLer have been aacctedj „a,a „ype w4l b cued CTIVENTS --Ise this space to ele-`__.ite ;,,m an-;, a " .ctc of she jcc i at.z-L,
<br /> Fx al<xrg Water” ��crz:y l, or . ,
<br /> na.,ar indicateindicate :f ��<r, �r z.,crro m� .„c�.p� ,
<br /> o-me_ti xter wells tsva actually uall" be"naffectee, . GroundWater' �,XGNATTRRE � the form in ut.:s, _,_a..e p_e,a..a,l.
<br /> d aaa on dcas rot �-Ly thata: t.._ <.f-fc,t;teca artz'�e,° >wdnz`so', ,,a, or is,
<br /> used for Ir inking watoo but only .,.has -water wells have notybt ben) :ac rt,
<br /> effects& it .... _..ocd°,.>r,a<. case type za. t,h"x>£,e zxpo. rrAt tl?ar if the, Svrr; t M aay the .._., „:,<nE.r ox his agent, retain ,_.r.
<br /> zt f1a, vr,. and forwamlthe copies xaa.,,w0 t a y,,a:a Imat tank pmmAting paz<,�,',
<br /> 4 t s
<br /> Mcal T, xrr ?
<br /> �; f so.zy w,ii t -'_ _ .� .,a
<br /> 1
<br /> s Agency
<br /> _ray_ >.ka t c _„c_; It ;ax Y,., f,aavtt., rst wa_t <;e.. 2, u<'se .,- R ,ource> .onL oy ? a _x, Clca_ _zi. _ 1x,.3,
<br /> �. _.
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<br /> w ,. .� r_ ri:F_, .h., _c. +` on..e .1.0_,? <, relative �,=a't: a�. t�, �x�� md..c,,_tsum,, 'Saszc __ .N <. . . o_. ;i. a_,. u._ '_ ;•<,
<br /> ,,. .%r�� is -01"d z: l ,. - vTi vho'ul,,�,
<br /> to the z,: of4he },,.au_td af,-r .. <.r,�>. t xp �. �_e.. � __ F e.a_.L%',. L,f<z.ta...i.
<br /> w
<br /> .»1.e, of to a_a ¢ s->,.. .,,, �,_ c s� �. '�cc,aw T _ rF,._.uz tato E �azf, .t<>�r _ _ c
<br /> f,.
<br /> No
<br /> oi, ,irk.
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