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UNIFIED PROGRAM CONSOLIDATED FORM TANK: TA0152803 PR#: PR0231528 UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC#: FA0003795 (two pages per lank) Page f5 TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PFRMIT ❑ 5 CH 3\(;E OF INFORMATION ❑ 6TEMPORARY SITECLOSURE (Cn mly bam wy) ❑ 7 PERMANENTLY CLOSED ON SITE lJ (Sptriy rcaon.f«locaf me�lY) (Spai%ewwn-t kcal uceony) ❑ STANK REMOVED 43 ❑ 3RENEWAL PERMIT BUSINESS NAME(sauca4FACILDNNAME«DBA-Doing Bu4i aAs) FACILI FY ID: PR#: ) LIBERTY RURAL FIRE DISTRICT FA0003795 PR0231528 ( j LOCATION WITHIN SITE(0,,m!) 24124 N BRUELLA RD,ACAMPO 431 PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location ofthe UST system irrcluding buildings and landmarks shall be sobnutled to the local agency.) TANK[D# Tank#: 3 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ❑No 434 TA0152803 IPYn",campkumepage fm«n enmpammmf DATE W STALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 525 ADDITIONAL DESCRIPTION(F_ imcowy) 438 H.TANK CONTENTS TANKUSE 439 PETROLEUM TYPE 4w ® 1.MOTOR VEHICLE FUEL ® la.REGULAR UNLEADED Cl 2.LEADED ❑ 5.JET FUEL (Ifmarked«rok4e PcnolmnType) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL [16.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic MIDGRADEUNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(6mn xarnmm m.onablur«wy Pagn) T7, S#(6omxanrdou4 Mmomab lm«ory page) 442 El 4.HAZARDOUS WASTE (IwoUa Dip Fl 95.UNKNOWN Hl.TANK CONSTRUCTION TYPEOFTANK ❑ 1.SINGLEWALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Clark orc iwu may) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIAL-primary lank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (clack mctt�u uuly) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) [199.OTHER TANK MATERIAL-secondary lank ❑ 1.HARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (CTerk one igen.1y) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W(FIBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑".OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ LRUBBERLINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING E]95.UNKNOWN 446 DATE INSTALLED uv OR COATING (Chink one it my) ❑2ALKYD LINING ❑4PHENOUC LINING E]6UNLINED ❑ 99.OTHER (Fur oral me ady) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN Hs DATE INSTALLED N9 PROTECTION IF APPLICABLE PROTECTION (CTmkimn may) E]4IMPRESSED CURRENT ❑ 99 OTHER ❑ 25ACRIFICIAL ANODE (Fmkral mcany) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(lowlm oofy) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chale all Nat appy) ❑ I SPILL CONTAINMENT ❑ IALARM ❑ 3 FILL TUBE SHUT OFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑4 EXEMPT ❑ 3STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A docdpfim of me m Wringpro8rem 5nil ee subminWW d loralawry.) IF SINGLE WALL TANK(4 kali rent apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Choi oue nem may) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSEZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIA.? 452 ❑ Yes ❑ No UPCF(12/99 revised)