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UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS -TANK PAGE 1 <br /> �� � /'S (IYro Pages per tone <br /> Yd <br /> 11 Paga _ of _ <br /> TYPE OF ACTION LJ 1.NEW SITE PERMIT ❑ 4.AMENDED PERMIT ❑ S. CHANGEOFINFORMATION) ❑ 6. TEMPORARY SITE CLOSURE <br /> TYPE <br /> Caro ,) ❑ 7. PERMANENTLY CLOSED ON SITE <br /> ❑3.RENEWAL PERMIT (SOIPIA•metpn-FerroCal v»PryY) (Sealy cAargs-rorloul uae Dory) ❑ S. TANK REMOVED 430 <br /> BUSINESS NAME(Soma H FACILITY NAME w OBA-DoifN Buevwss Aa) FACILITY 106 <br /> Joe Omachi Property <br /> LOCATION WTHIN SITE(OPd.W 431 <br /> I.TANK DESCRIPTION <br /> TANK ID6 TANK MANUFACTURER COMPARTMENTALIZED TANK ❑ Ya1 10 No <br /> If Y4f..,I.m Pne P49e W Ma -P+ Sm <br /> nkn <br /> kW <br /> DATE INSTALLED(YEARIMO) TANK CAPACITY M GALLONS NUMBER OF COMPARTMENTS <br /> Unknown 550 gal . 1 <br /> ADDITIONAL DESCRIPTION PWua oNy) <br /> IL TANK CONTENTS <br /> {ya. TANK USE 432 PETROLEUM TYPE rtf�T <br /> LJ 1. MOTOR VEHICLE FUEL ❑IS REGULAR UNLEADED Ifo 2. LEADED ❑ 5. JET FUEL <br /> (Mnlark4q mmplMa Patmlwm Tye) ID. PREMIUM UNLEADED ❑ 3. DIESEL ❑ B. AVIATION FUEL <br /> ❑ 2. NOWFUEL PETROLEUM ❑1c MIDGRADEUNLEADED ❑ 4. GASOHOL [I W. OTHER <br /> ❑ 3. CHEMICALPROOUCT COMMON NAME Mm Hazalloua Materials lnronfpry papa) CASS(h HtZSl Ya MSM SMn SW ryPaps) <br /> ❑ 4. HAZAROOUS WASTE(IA . <br /> 0a0D0) Gasoline <br /> 171 SS IINKNOW4 <br /> IS.TANK CONSTRUCTION <br /> TYPE OF TANK 1. SINGLEWALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL NTH INTERNAL BLADDER SYSTEM <br /> (CAaCk oru Kem aral9 ❑ 2. DOUBLEWALL EXTERIOR MEMBRANE LINER [195. UNKNOWN <br /> ❑ 4. SINGLE WALL IN A VAULT C1 N OTHER <br /> TANK MATERIAL-Plmay lank 141 RARE STEEL ❑ 3. MBERGLASSIPLASTIC ❑ 5. CONCRETE 09. UNKNOWN <br /> (CINck Pru awn aMyy ❑ 2. STAINLESS STEEL 04. STEELCLADWIFIBERGLASS ❑ 6. FRP COMPATIBLE WIIW%METHANOL 1:1 W. OTHER <br /> REINFORCED PLASTIC(FRP) <br /> TANK MATERIAL-NKgMMy tS* 0 1 BARE STEEL ❑ 3. FIBERGLASS I PLASTIC ❑ 6. FRP COMPATIBLE W/1W%METHANOL ❑95. UNKNONM <br /> (CReckam ihm Dory) ❑ 2. STAINLESS STEEL ❑ 4. STEEL CLAD W/FIBERGLASS ❑ 9. FRP NON-CORRODIBLE JACKET 0 OTHER <br /> REINFORCED PLASTIC(FRP) [110. COATED STEEL <br /> ❑ 5. CONCRETE F'1 <br /> TANK COATING <br /> LINING 1. RUBBER LINED ❑ 3. EPDXY LINING yp 5. GLASS LINING ❑95. UNKNONM433 DATE INSTALLED <br /> OR COATING LXy. <br /> ❑ Z. ALKYD LINING ❑ 4, PHENOLIC LINING e. UNLINED ❑89. OTHER Fwronl vaa ) <br /> LAxk ar�Hm i.T <br /> OTHER CORROSION 0 1 MANUFACTURED CATHODIC ❑ 3. FIBERGLASS REINFORCED PLASTIC 1a 95. UNKNOWN 431 DATE INSTALLED <br /> PROTECTION IF APPLICABLE PROTECTION <br /> ❑ 4. IMPRESSED CURRENT 0. OTHER <br /> (Crock arM item enM ❑ 2. SACRIFICIALANODE (FwloW uw wtly) <br /> SPILLANDOVERFILL YEAR INSTALLED TYPE(FarkKal uxe way) OVERFILL PROTECTION EQUIPMENT'.YEAR INSTALLED <br /> (CMPAaI MM apply) 0 1 SPILL CONTAINMENT ❑ 1.ALARM ❑ 3. FILLTUSESHUTOFFVALVE e <br /> ❑ 2. DROPTUBE none ❑ 2. BALL FLOAT none 4 EXEMPT <br /> ❑ 3. STRIKER PLATE none <br /> N.TANK LEAK DETECTION <br /> IF SINGLE WALL TANK 0 fMt a )' IF DOUBLE WALL TANK OR TANK WTN BLADDER CIlecR wM AS..10 <br /> ❑ 1, VIWAL(EXPOSEDPORTION ONLY) ❑ 5. MANUAL TANK GAUGING(MTG) ❑ 1. VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑ 2. AUTOMATIC TANK GAUGING(ATG) ❑ 6. VADOSE ZONE ❑ 2. CONTINUOUS INTERSTITIAL MONITORING <br /> ❑ 3. CONTINUOUSATG ❑ 7. GROUNONATER ❑ 3. MANUALMONITORING <br /> ❑ 4. STATISTICALINVENTORYRECONCILIATION(SIR)• ❑ 6. TANKTESTING <br /> BIENNMLTANKTESTING ON, OTHER nnnp <br /> V.TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE <br /> ESTWTEO DATE LAST USED(YR WAY) ESTIMATED QUANTITY OF SUBSTANCE REMAINING 435 TANK FILLED NTN INERT MATERIAL'! <br /> gatlanl ❑Yas ❑No <br /> CUPAFORM(4199) Formerly SWRCB Form B <br />