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REMOVAL_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231233
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REMOVAL_2022
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Last modified
1/23/2023 3:37:52 PM
Creation date
12/5/2022 8:30:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
2022
RECORD_ID
PR0231233
PE
2361
FACILITY_ID
FA0002479
FACILITY_NAME
7-ELEVEN INC #17334
STREET_NUMBER
4501
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11017004
CURRENT_STATUS
01
SITE_LOCATION
4501 N PERSHING AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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SANJ O A Q U I N Environmental Health Department <br /> COUNTY <br /> 6 . A copy of the submitted " Health and Safety Plan " must be on the jobsite for review . <br /> 7 . A copy of the fire department permit must be submitted at the time of removal . <br /> 8 . A copy of this approval letter and the EHD permit packet shall be on site during tank excavation <br /> and removal . <br /> 9 . If the removed backfill material and soil is found to be contaminated it must be disposed of at <br /> an approved disposal location . Treatment of soil on site can only be performed under a <br /> hazardous waste treatment permit . <br /> 10 . See ` Sampling Protocol for Routine Tank Removals ' and `Verification Analysis ' on page 6 and 7 <br /> of the permit application for required analytical tests and number of samples to be taken and <br /> witnessed by EHD . <br /> 11 . The following information must be submitted within 30 days after the UST removal date : <br /> a . Analytical results : Only results that come directly from a third- party California certified <br /> laboratory with affixed chain of custody will be accepted by EHD <br /> b . UST Disposition Tracking Record and/or hazardous waste manifest for tank and piping <br /> c . Hazardous Waste Tank Closure Certification form ( DTSC Form 1249) <br /> d . Hazardous waste manifest for rinsate and residual product <br /> 12 . Permit expires 180 days from the date of approval . If an extension to the expiration date is <br /> required , a written request must be submitted to this office prior to the expiration date . <br /> If you have any further questions , please contact me at ( 209) 616-3028 . <br /> Thank you , <br /> Vicky Vang - Lee <br /> Registered Environmental Health Specialist <br /> Cc: Burke Albelda , bdalbelda@speedway . com <br /> 2 of 2 <br />
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