BILLING_1997-2003 - Laserfiche WebLink

Home Browse Search

IED PROGRAM CONSOLIDATED FORM 4P TANK: TA0507938 PR#: PRO231074 UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC#: FA0002541 (two pages pertank) Pegc 2 0 TYPE OF ACTION ❑ I NEW SITE PERMIT ❑4 AMENDED PERMI I' ❑ 5 CHANGE OF INFORMATION El TEMPORARY SITE CLOSURE (Cloak only item only) L] ]PERMANENTLY CLOSED ON SITE (Spm[,rayon-for lwal tce only) (SpMly rmsw [ 1 IracoN}) 3 RENEWAL PERMIT �.._� ❑ e TANK REMOVED �s BUSINESS NAME(samcaa FACILI3 NAMEor DRA-Mo gBwinms As) FACILITY ID PR#: 1, I IJ 7 ELEVEN STORE#20632 B/2237 FA0002541 PR0231074 ` // LOCATION WITHIN SITE(opts na0 4627 DA VINCI DR,STOCKTON 411 /3' PHONE VV I.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including bwldings and landmarks shall be submitted Io the local agency.) n..g k TANK ID# Tank#: 4 412 TANKMANUFACTURER 411 COMPARTMENTALIZED TANK ❑Yes []No434 .Np /Y��u TA0507938 TOTAL CONTAINMENT If-Ya'.aon hnnepage fm haompa mmt. 1-0 DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 ✓� 4/29/1998 10,000 ADDITIONAL DESCRIPTION(F.kaal an only) 438 IL TANK CONTENTS l TANK USE 439 PETROLEUM TYPE 440 ® 1.MOTOR VEHICLE FUEL ® la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL pfnurkdmmplae Pamlawn Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑2.NON-FUEL PETROLEUM ❑ Ic MMORADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAMEraonaxa:saaam Ma nab lnvaut tmm Hva Materials lmmta a ( mYWBe) CAS#441 ( nPe g) 441 ❑4.HAZARDOUS WASTE (Ikkaa Used 00) ❑95.UNKNOWN HL TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ((MMck on not only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ® I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 ((Meckomiumonly) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD WTIBERGLASS ❑ 8.FRP COMPTIBLE W/100°%METHANOL REINFORCED PLASTIC(FRP) ❑99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chat on item only) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100°%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL99.OTHER [j5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LVED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING (Cbskomidmonly) ❑2ALKYD LINING ❑ 4PHENOLIC LINING ®6UNLINED ❑ 99.OTHER (Palaal ua only) OTHER CORROSION ® 1 MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC [j 95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Chakaao naaanly) E]4 IMPRESSED CURRENT E] 99 OTHER ❑ 2SACRIFICIAL ANODE (For locel use Daly) SPILL AND OVERFILL YEAR INSTALLE45o TYPEOoalmconly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chak all tot apply)'I SPILL CONTAINMENT 1,998yt* I ALARM �El FILL TUBE SHUT OFF VAL` 2 DROP TUBE IY�D 2 BALL 1 er{Q ❑ 4 EXEMPT 3 STRIKER PLATE FLOAT met¢ IV.TANK LEAK DETECTION(A descriptionorux monimrim pmsmm swn nc sutnucd to tklmal agony.) IF SINGLE WALL TANK(Chat all ma apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chak arc itan ady) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 comTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK 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 MATERIAL? 457 4/29/1998 0'00 gallons ❑ Yes ❑No UPCF(12/99 revised)