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COMPLIANCE INFO_2013-2018
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231309
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COMPLIANCE INFO_2013-2018
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Last modified
8/12/2022 4:20:10 PM
Creation date
6/23/2020 6:45:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2018
RECORD_ID
PR0231309
PE
2361
FACILITY_ID
FA0003756
FACILITY_NAME
KISHIDA, GEORGE INC
STREET_NUMBER
1725
STREET_NAME
ACKERMAN
STREET_TYPE
DR
City
LODI
Zip
95240
APN
06219001
CURRENT_STATUS
01
SITE_LOCATION
1725 ACKERMAN DR
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\UST\UST_2361_PR0231309_1725 ACKERMAN_2013-2018.tif
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EHD - Public
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11 <br />5. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? <br />b. Identify contractor performing decontamination: <br />Name <br />Address <br />c. Describe method to be used for decontamination: <br />YES[] <br />NO[] <br />FNVIRONMENT <br />Phone ( , 22h <br />City Zip_ <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone (� <br />Address it, <br />Permitted Disposal Site <br />6. a. Describe the method that will be utilized to purge and/or ine he piping: <br />b. Piping Hauler: <br />Name <br />Address <br />Hauler Registration # (if hauled as I <br />c. Piping Disposal Site: <br />Name <br />Address <br />EPA ID# (if transported to a perm' ei <br />7. Is the sampling firm an independe third <br />a. Identify sampling firm: <br />b. Identify laboratory <br />Name <br />Address <br />8. Describe, in detail, hal <br />TSD <br />ing analysis: <br />from <br />Hauler Reg# _ <br />Zip <br />Phone (� <br />City Zip <br />rnone <br />City Zip <br />YES [ ] NO [ ] <br />_ Phone( <br />City Zip <br />Phone ( ) <br />City Zip <br />the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br />9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name Hauler Registration # <br />Address City <br />b. If soil is not to be hauled, describe what will be done with it: <br />EH230038 (revised 12-11-15) 4 <br />Phone (� <br />Zip <br />
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