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MAY-20-2005 11 :32 RM RAH ENVIRONMENTAL INC 916 652 8955 P. <br /> C1 TJ 8'2305- <br /> UNIFIED PROGRAM CONSOLIDATED FO 10 i3 TANKS <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 1 <br /> (two pages per tank) <br /> pale�ar_ i <br /> TYPE OF ACTION ❑1 NEW SITE PERMIT Q 4 AMENDED PERMIT Cl 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE <br /> (Chat a+n �«ly) ❑ 7 PERMANENTLY CLOSED ON SITE <br /> ❑ 3 RENEWAL PERMIT (Spiny amw-r«I«Y oe anM (spaety -faleal=Only) 9 TANK REMOVED Oa <br /> BUSINESSNAME(sameaFAacIrY NAMIB aDBA-n«a 9utlavaM FACILITYID: <br /> 3 <br /> LOCATIO wAr C�1 e p 0 .31 <br /> �i ` o e2h c2�t i h. <br /> I. ANK D SC PTION scakd pl an with the location of the UST system including buildings and land ancas I be subTrdtted M the ocal agncy.) <br /> 7DA <br /> 3 TANK MANUFA RER 633 OMPARTME ED TANK Yea A ( O O) 43 TAN APA I IN G LONS 36 NUM E MPAR S .37 <br /> rlfWAI <br /> ADDITION L DESCRIPTION(Falaad me-1y) 433 <br /> n.TANK CONTENTS <br /> "fANK USE 43 E 410 <br /> x1. MOTOR VEHICLE FUEL I]la. REGULAR UNLEADED [12. LEADED [35. JET FUEL <br /> I tl aanptae Peeelemn Typal [I Ib. PREMIUM UNLEADED ❑3. DIESEL 06. AVIATION FUEL <br /> ❑2 NON-FUEL PETROLEUM ❑Ic. MIDGRADE UNLEADED C14 GASOHOL 99.OTHER WLIS4 U{I <br /> ❑3. CHEMICAL PRODUCT COMMON NAME, (,naa glade« Mataiab lav 4ay paa) CA #(fmm Hmrdo«Musiab tn.mary pas) 44z <br /> 4. HAZARDOUS WASTE Wal I e .n-t ' <br /> (1« Used ou) c t <br /> ❑95.UNKNOWN <br /> T K ION <br /> A 1. ALL 3, S L 5. LE AL BLADDER SYSTEM M] <br /> TYPE OF <br /> i..1y) EXTERIOR MEMBRANE LINER 0 9. UNKNOWN <br /> El 2. DOUBLE WAIL ❑4. SIGNLE WALL IN VAULT ❑99. OTHER_ <br /> TA -peimry bet 1. 0 /PLASTIC N 95, UNKNOWN 444 <br /> (Chea«e 1.ah) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FBERGLASS ❑s. FRP COMPTBLE W/100%METHANOL ❑99.OTHER <br /> REINFORCED PLASTIC(FRP) <br /> TANK _..�,,� Cl 1, B 3. O PLA C 5. CONLIM44 <br /> (Chat aie leen aaly) [32. STAINLESS STEEL [34. STEEL CLAD W/PBERGLASS ❑a. FRP COMPTBLE W/100%MErI1ANOL ❑99.OTHER <br /> REINFORCED PLASTIC(FRP) ❑10.COATED STEEL <br /> ❑5. CONCRETE <br /> TANK OR O 1. 7. S.GLA L 9 . OWN DA W <br /> Nopjvt <br /> OR COATING ❑2 ALKYD LINING ❑4 PIIHNOLIC LINING yq s6 UNL NED ❑99 OTHER <br /> (Ch .jwwa.ly) T .1y)OTHER CORROSION 1 MANUFACTURED CATHODIC <br /> El FIBERGLASS REINFORCEDPLASTIC 1 95 UNKNOWN <br /> PROTECTION IF APPLICABLE PROTECTION ❑4IMPRESSED CURRENT b OTHER <br /> (Disk o«iron any) E32 SACRIFICIAL ANODE (Fa bol u««y) <br /> ILL OV ST 4 (Leal ea«M 41 V R ON ALLED 4 <br /> (Chalt as IMst apply) ❑1 SPILL CONTAINMENT 0 I ALARM ❑3 FILL TUBE SHUT OFF VALVE <br /> �h n ❑2 DROP TUBE ❑2 BALL FLOAT _ ❑4 EXEMPT <br /> L/ ❑3 STRIKER PLATE <br /> TANK LEAK DETECTION(A deaipdai abb.—hong Paarem ahYlb aala`*aI m Ne lain eatnry.) <br /> IF SINGLE WALL TA (CkskAh.w0y) 4 3 IF WUBLE WALLOR TANK WITH BLADDER 454 <br /> (Oia2 me Men ady) <br /> Cl 1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑2 AUTOMATIC TANK GAUGING(ATO) ❑6 VADOSE ZONE ❑2 CONTINUOUS INTERSTITIAL MONITORING <br /> ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING <br /> ❑4 STATISTICAL INVENTORY RECONCILIATION ❑e TANK TESTING R 0032 <br /> (SIR) BIENNIAL TANK TESTING99 OTHER <s'aT/�r rf <br /> TV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE INP ACE <br /> ESTIMATED DATE L 417 <br /> US,E�D1(Y/R/MO/DAY) 55 ESNSATED QUANTITY OF SUBSTANCE REMAINING 45 TANK FELLED WITH T MATERIAL^ <br /> hV W v Aja gallons ❑Ycs NO J <br /> UPCF(1/99 revised) 173 Formerly SWRCB Form B <br />