BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

I 161 D,3 NIFIED PROGRAM CONSOLIDATED FORT` TANK: TA0184807 PR#: PR0231848 UNDER%,ROUND STORAGE TANKS - TANK PAGE 1 FAC#: FA0002052 (two pages per(ank) Page 6 of 7 TYPE OF ACTION n 1 NEW SITE PERMIT n 4 AMFNnF.D PERMIT n S(HANGS OF INFORMATION []6 TEMPORARY SITE.CLOSURE (Check only item only) 7 PERMANENTLY CLOSED ON SITE 3 RENEWAL PERMIT (Specify reason-fm tical use poly) (Specify canon-for local use only)% 8 TANK REMOVED 430 111 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) FACILITY ID: PR#: 1 ST SERVICES FA0002052 PR0231848 LOCATION WITHIN SITE(Optional) 3505 NAVY DR,STOCKTON 431 PHONE zC)q, (`/3. �6 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# Tank#: 7 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes No 434 TAO 184807 v If"Yes",complete arc page for each compartment- DATE INSTALLED(YEAR/MO) 435 TANK CAF YIN GALLONS 436 NUMBER OF COMPARTMENTS Jt7 AIA_ 1,000 ADDITIONAL DESCRIPTION(For local use only) 438 3/06/00 CHING PE FR 2315 TO 2360 PER MK.LBR 11.TANK CONTENTS TANK USE 439 PETROLEUM TYPE S40 ❑ 1.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (If marked complete petroleum Type) ❑ Ib.PREMIUM UNLEADED CX3.DIESEL ❑ 6.AVIATION FUEL ® 2.NON-FUEL PETROLEUM ❑ I c.MIDGRADE UNLEADED ❑4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME ❑ (from,Hazrdow Materials Inven°ry page) 441 CASH(from Hazardous Materials Inventon Pa e ) 442 4.HAZARDOUS WASTE (Includes Used Oil) ❑ 95.UNKNOWN til-met rat 111.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER ❑95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIAL-primary tank ❑ I.BARE STEEL 1$ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (Check one item only) ❑ 2.STAINLESS STEEL ❑STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100°A METHANOL REINFORCED PLASTIC(FRP) ❑99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Check one item only) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/1000/6 METHANOL REINFORCED PLASTIC(FRP) ❑ to.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑3.EPDXY LINING ❑ 5.GLASS LINING 95.UNKNOWN 446 DATE INSTALLED 447 OR COATING (Check one item only) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ❑ 6 UNLINED ❑99.OTHER (for local use only) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC 95 UNKNOWN 449 DATE INSTALLED a49 PROTECTION IF APPLICABLE PROTECTION (Check one item only) ❑4 IMPRESSED CURRENT ❑ 99 OTHER ❑ 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) ❑ 1 SPILL CONTAINMENT B I ALARM ❑ 3 FILL TUBE SHUT OFF VAL' ❑ 2 DROP TUBE ❑ 2 BALL 4 EXEMPT ❑ 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Check one it-only) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER [S] 2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BI ❑ 99 OTHER NK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED/DATE LAST USED(YR/MO/DAY) 455 JESTIMATED QUANTITY OF SUBSTANCE REMAINING ash TANK FILLED WITH INERT MATERIAL? 457 bZ ❑ Yes ❑ No UPCF(12/99 revised) 4