BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

A NIFIED PROGRAM CONSOLIDATED FORDf TANK: TA0184806 PR#: PR0231848 UNDERGROUND STORAGE TANKS - TANK PAG j ) a3 FAC#: FA0002052 (two pages per tank) TYPE OF ACTION n I NEW SITE PFRMIPage 4 of 7 T n 4 AMFNDFII PERMIT n ;f IIANriI OF iNFnR%I%fIr1N n 6 TEMPORARY SITE CLOSIIRF. (Check only item only) ❑ 7 PERMANENTLY CLOSED ON SITE 3 RENEWAL PERMIT (Spedfy,reason•for total me only) (specify reason-for local iae Doty) ❑ 8 TANK REMOVED 430 BUSINESS NAME(Same as FACILITY NAME or DBA.Doing Business As) FACILITY ID: PR#: 1 ST SERVICES 3 EFA0002052 7 PR0231848 LOCATION WITHIN SITE(optional) 3505 NAVY DR,STOCKTON 471 PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be subrnitted to the local agency.) TANK ID# Tank#: 6 432 TANK MANUFACTU_R 477 COMPARTMENTALIZED TANK ❑Yes ( No 434 TA0184806 If"Ye".complete one page for each compartment. (' DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 41' N j' 6,000 ADDITIONAL DESCRIPTION(For local useonly) 3/06/00 CHNG PE FR 2315 TO 2360 PER MK.LBR 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ❑ I.MOTOR VEHICLE FUEL ❑ I a.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL 440 (IfmarkedcompletePetroleum Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL M 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑ 4.GASOHOL ® 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAMEfrom Hazardous Materials Inventory ry page) 441 CAS#(from Hazardous Materials Imrntory page) 442 F14.HAZARDOUS WASTE (Include Used Oil) ❑ 95.UNKNOWN Zkr7 dkIwaW III.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 ❑ ".OTHER TANK MATERIAL-primary tank ❑ I.BARE STEEL ® FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (Chock one item only) ❑ 2.STAINLESS STEEL ❑STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ ".OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ®3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 (Check one item enly) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ I.RUBBER LINED OR COATING ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ®95.UNKNOWN 446 DATE INSTALLED 447 (Check one item only) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ❑6 UNLINED ❑99.OTHER (For local we only) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ❑ PROTECTION IF APPLICABLE PROTECTION 3 FIBERGLASS REINFORCED PLASTIC QQ 95 UNKNOWN 448 DATE INSTALLED 449 W (Check ate item only) ❑4 IMPRESSED CURRENT ❑ 99 OTHER E] 2 SACRIFICIAL ANODE (Fa tical use only) SPILL AND OVERFILL YEAR INSTALLE45o TYPE(local useonly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) ® I SPILL CONTAINMENT ✓ ALARM ❑3 FILL TUBE SHUT OFF VAL' ❑ 2 DROP TUBE ❑ 2 BALL K 4 EXEMPT ❑ 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A description of the monitoring program shalt 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) (Cheek one non only) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING (SIR)BIENNIAL TANK TESTING ❑99 OTHER 3 MANUAL MONITORING ❑ 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 ❑ Yes ❑ No UPCF(12/99 revised)