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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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BLACK DIAMOND
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2800 - Aboveground Petroleum Storage Program
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PR0515676
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
3/19/2019 4:16:29 PM
Creation date
10/17/2018 11:50:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2800 - Aboveground Petroleum Storage Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0515676
PE
2832
FACILITY_ID
FA0003775
FACILITY_NAME
TIGER LINES INC
STREET_NUMBER
927
Direction
E
STREET_NAME
BLACK DIAMOND
STREET_TYPE
WAY
City
LODI
Zip
95240
APN
04903033
CURRENT_STATUS
01
SITE_LOCATION
927 E BLACK DIAMOND WAY
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EJimenez
Tags
EHD - Public
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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/21/2010-01:33:06 P <br /> Page of <br /> L FACILITY INFORMATION <br /> BUSINESS NAME <br /> <br /> TION 201 rCAL LOCATION C <br /> FUEL ISLAND ❑R YES❑NO <br /> FACILITY I:)# 11 14A <br /> Required <br /> RID#by SJ1/E-4 � /A /A /A 203/204 <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET'(11) ❑YES ®NO 206 <br /> MOTOR OIL If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 208 <br /> MOTOR OIL EHS* ❑YES ONO <br /> CASA 209 <br /> MIXTURE *If ERS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HA E Check oneMEi TERI L 3 a.PURE ®b.MIXTURE (3c.wASTE 211 RADIOACTIVE❑YES N NO 212 CURIES 213 <br /> PHYSICAL STATE ❑SOLID IST LIQUID ❑GAS 214 LARGEST CONTAINER 1000 215 <br /> (Check one item only) <br /> FID HAZARD CATEGORIES ®FIRE ❑REACTIVE ❑PRESSURE RELEASE ®ACUTE HEALTH ®CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 500 11,000 N/A N/A <br /> UNITS* ®GAL ❑CU FT ❑LBS ❑TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only *If EHS,amount must be in pounds. 1365 <br /> STORAGE ®ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO ❑PLASTIC BOTTLE <br /> ®TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM ❑BAG ❑TANK WAGON <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BOR ❑RAIL CAR <br /> ❑CAN ❑CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste onl EHS CASA <br /> 226 227 ❑YES ❑NO 228 229 <br /> 230 231 ❑YES ❑NO 232 233 <br /> 234 235 ❑YES ❑NO 236 237 <br /> 238 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS IDA(DOT) 1270 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? VEHICLE MAINTENANCE <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />
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