BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

a ` FIED PROGRAM CONSOLIDATED FORM K: TA0150903 PR#: PR0231509 UNDERGROUND STORAGE TANKS - TANK PA I V*AC#: FA0003809 7 Q (two pages per tank) Page 2 cf 7 TYPE OF ACTION ❑ I NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (C6akenlybonmly) I'll ❑ 7 PERMANENTLY CLOSED ON SITE 3 RENEWAL PERMIT ❑8TANK REMOVED 430 BUSINESS NAME(Samc as FACILITY NAME«DBA-notes, u wAnFACILITY ID: PR#: 1 A G SPANOS AVIATION DEPT 3 FA0003809 PR0231509 LOCATION WITHIN SITE(optional) 4800 S AIRPORT WAY,STOCKTON 431 PHONE (209 ) 982-1550 I.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted t0 the local agency.) TANK ID# Tank#: 3 432 TANK MANUppFACTCU/RERR 433 COMPARTMENTALIZED TANK ❑yes o 434 TA0150903 T1�uSGo v^rm^,complaco«p.9err«cn mnPmmm3 DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY INGALLONS 436 NUMBER OF COMPARTMENTS 437 20,000 ADDITIONAL DESCRIPTION(F«kcal we only) 439 H.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ,j17(/ a4o T 1.MOTOR VEHICLE FUEL ❑ Ia.REGULAR UNLEADED ❑ 2.LEADED ® 5.JET FUEL 0fmaded<ompktePmolemn Type) ❑ Ib.PREMIUMUNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑2.NON-FUEL PETROLEUM ❑ Ic MIDGRADEUNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(cam Banraom Mami.b lmmmrypa9e) 441 CAS#(6omnaaardom Mmcdak lo,m ow page) 442 ❑4.HAZARDOUS WASTE (Indu usmoJ) ❑ 95.UNKNOWN ID.TANK CONSTRUCTION TYPE OF TANK ❑ L SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Ch one ileo Holy) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (Cn«k one item only) ❑2.STAINLESS STEEL 'STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 (Ch«k on item only) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ I.RUB13ERLYNED E] 3.EPDXY LINING E] 5.GLASS LINING E]95.UNKNOWN 446 DATEINSTALLED an OR COATING (Ch«ka«itanonly) ❑2ALKYD LINING E]4PHENOLIC LINING ❑ 6UNLINED ❑ 99.OTHER bolus (F« cmy) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED a9 PROTECTION IF APPLICABLE PROTECTION ❑4IMPRESSED CURRENT ❑ 99 OTHER (CT«kmo mo off) ❑ 25ACRffICIAL ANODE (Fmlonl ueanly) SPILL AND OVERFILL YEAR INSTALLE45o TYPE(lecal«emly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (CnN�all Jot apply) '� 1 SPILL CONTAINMENT ❑ 1 ALARM 3 FILL TUBE SHUT OFF VALr 2 DROP TUBE ❑ 2 BALL 4 EXEMPT 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A ducripum ofa,e amemring pro,ma doll be sui minmm no local egmey.) IF SINGLE WALL TANK(C kall not apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER ]457 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Cnskarcitrn only) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? ❑Yes ❑No UPCF(12/99 revised)