BILLING_1997-2003 - Laserfiche WebLink

Home Browse Search

IED PROGRAM CONSOLIDATED FORM TANK: TA0507948 PR#: PR0231462 UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC#: FA0000508 (two pages per tank) Page 2 o TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Chink only lt=o y) ❑ 7 PERMANENTLY CLOSE NSII EE 3RENEWAL PERMIT ..(Spm f3 oo-tor local lsseo JJ lspm hru=oo-forlorai iamN)) ❑8TANK REMOVED /' BUSINESS NAME(s.me as FACILITY NAME or DBA.Doing Bmmns As) FACILITY ID: PR q 1 7 ELEVEN#17647 B/2237 3 FA0000508 PR0231462 b LOCATION WITHIN SI I h(Oprimd) 1048 W YOSEMITE AVE,MANTECA d31 ft PHONE (/ I.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings a2d landmarks shall be subrmtted to the local agrncy.) TANK ID# Tank#: 4 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ❑No 434 y�I TA0507948 TOTAL CONTAINMENT ime,-,mjmleumepagrormchWn ,mnmt � DATE INSTALLED(YEAR/MO) Q5 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 5/1/1998 10 000 71� ADDITIONAL DESCRIPTION(Fcrl l a co y) 439 IL TANK CONTENTS TANK USE 43p PETROLEUMTYPE 44a ® I.MOTOR VEHICLE FUEL ❑ Ia.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Ifmad oee,lacPmolmm TWc) ® Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL ❑2.NON-FUEL PETROLEUM ❑ Ic.M03GRADE UNLEADED ❑4.GASOHOL ❑ 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(rmm H.&.Matcdab mrmmrypagc) 441 CAS#(aam Hamrdma Materials Immlory page) 442 ❑4.HAZARDOUS WASTE (IncludesUsed Oi) ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (CMck=item only) 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 N4 (Check one iron mly) ❑2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (C onei...I,) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100" METHANOL REINFORCED PLASTIC(FRP) E] 10.COATED STEEL 99.OTHER ❑ 5.CONCRETE -TA'NlC7L-)"W TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 097 OR COATING (Cheekcnci=a Iy) ❑2ALKYD LINING ❑ 4PHENOLIC LINING El 6UNLINED ❑ 99.OTHER (Parbwl use oNy) OTHERCORROSION ® I MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN "a DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ❑ (Checkoneilemanly) 4IMPRESSED CURRENT 99 OTHER ❑ 2SACRIFICIAL ANODE (Fmbuluuanty) SPILL AND OVERFILL YEAR INSTALLE450 TYPE 9ana1 me ony) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chink all N,1 appy) 1 SPILL CONTAINMENT 1,998A6ALARM ��R A El FILL TUBE SHUT OFF VAL` 2 DROP TUBE lqq g 2 gpLL 1 ❑ 4 EXEMPT 3 STRIKER PLATE (RIS FLOAT IV.TANK LEAK DETECTION(A dceiption orth ltodn9Pm m•ia116esa Maedto oeloeal.a=y.) IF SINGLE WALL TANKPMeekall ft wly) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Chico my) F-11 VISUAL(EXPOSED PORTION ONLY) E] 5 MANUAL TANK GAUGING(MTG) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ 1 VISUAL L(SINGLE WALL M VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTNUOUS INTERSTITIA.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 056 TANK FILLED WITH INERT MATERIAL? 457 5/1/1998 O.00 gallons ❑Yes ❑No UPCF(12/99 revised)