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BILLING_PRE 2019
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PR0231848
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BILLING_PRE 2019
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Entry Properties
Last modified
12/27/2023 1:24:48 PM
Creation date
11/5/2018 9:17:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231848
PE
2361
FACILITY_ID
FA0002052
FACILITY_NAME
NuStar Terminals Operations Partnership L.P.
STREET_NUMBER
3505
STREET_NAME
NAVY
STREET_TYPE
DR
City
STOCKTON
Zip
95206
APN
16203004
CURRENT_STATUS
01
SITE_LOCATION
3505 NAVY DR
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
KBlackwell
Supplemental fields
FilePath
\MIGRATIONS\N\NAVY\3505\PR0231848\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
11/8/2017 10:40:30 PM
QuestysRecordID
3721530
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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STATE OF CALIFORNik WATER RESOURCES CONTR BOARD <br /> FORM B : UND AGROUND STORAGE TANK PRiI..,"RAM =sem r mo <br /> TANK TANK PERMIT APPLICATION INFORMATION c" <br /> COMPLETE A SEPARATE FORM WITH THE FOLLOWING I FORMATION FOR EACH TANK. , <br /> I C` <br /> MARK ONLY ❑ 1 NEW PERMIT ❑ 3 RENEWAL PERMIT CHANGE OF INFORMATION ❑ 7 PERMANENTLY CLOSED T NK <br /> ONE ITEM ❑ 2 INTERIM PERMIT ❑ 4 AMENDED PERMIT ❑ 6 TEMPORARY TANK CLOSURE ❑8 TANK REMOVED <br /> w <br /> FACILITY/SITE NAME WHERE TANK IS INSTALLED: �0 S C� FARM TANK-YES❑ <br /> a) <br /> I. TANK DESCRIPTION COMPLETE ALL ITEMS-IF UNKNOWN-SO SPEC Y <br /> A. OWNERS TANK ID# B. MANUFACTURED BY: cr) <br /> C. YEAR INSTALLED D. TANK CAPACITY IN GALLONS: <br /> II. TANK 9ONTENTS IF(A.1),IS MARKED,COMPLETE ITEM C.IF(A.1),IS NOT MARKED,COMPLETE ITEM D. <br /> A. Ml MOTOR VEHICLE FUEL ❑ 2 PETROLEUM B. C. ❑ 1 UNLEADED ❑ 2 LEADED ❑ 3 DIESEL <br /> ❑ 3 CHEMICAL PRODUCT ❑ 4 OIL ❑ 1 ODUCT ❑ 4 GASAHOL ❑ 5 JET FUEL ❑ 6 AVIATION GAS <br /> ❑ 5 HAZARDOUS ❑ 80 EMPTY ❑ 95 UNKNOWN 2 WASTE ❑ 7 METHANOL 99 OTHER(DESCRIBE IN ITEM D,BELOW) <br /> D. IF NOT MOTOR VEHICLE FUEL,ENTER NAME OF i "�- a Ge-0 <br /> HAZARDOUS SUBSTANCE STORED&C.A.S.# te,f S A.S.#: <br /> III. TANK CONSTRYCTION MARK ONE ITEM ONLY IN BOX A,B,C,&D <br /> A. TYPE OF 1 DOUBLE WALLED 3 SINGLE WALLED WITH EXTERIOR LINER ❑ 95 UNKNOWN <br /> SYSTEM ❑ 2 SINGLE WALLED ❑ 4 SECONDARY CONTAINMENT ❑ 99 OTHER <br /> ❑ 1 STEEL/IRON ❑ 2 STAINLESS STEEL 'FIBERGLASS ❑ 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC <br /> B. TANK ❑ 5 CONCRETE ❑ 6 POLYVINYL CHLORIDE ❑ 7 ALUMINUM ❑ 8 100%METHANOL COMPATIBLE FRP <br /> MATERIAL <br /> ❑ 9 BRONZE ❑ 10 GALVANIZED STEEL ❑ 95 UNKNOWN ❑ 99 OTHER <br /> C. INTERIOR <br /> F-11 RUBBER LINED ❑ 2 ALKYD LINING F-] 3 EPDXY LINING ENOUC LINING <br /> LINING ❑ 5 GLASS LINING ❑ 6 UNLINED 95 UNKNOWN <br /> ❑ IS LINING MATERIAL COMPATIBLE WITH 100%METHANOL? ❑YES ❑ NO ❑ 99 OTHER <br /> D. CORROSION ❑ 1 POLYETHLENE WRAP ❑ 2 TAR OR ASPHALT ' RAP ❑ 4 FIBERGLASS REINFORCED PLASTIC <br /> PROTECTION ❑ 5 CATHODIC PROTECTION ❑ 91 NONE ❑ 99 OTHER <br /> IV. PIPING INFORMATION CIRCLE A IF AB E GROUND, U IF UNDERGROUND,BOTH IF APPLICABLE <br /> A. SYSTEM TYPE A U 1 SUCTION A 2 PRESSURE A U 3 GRAVITY A U 91 NONE A U 95 UNKNOWN A U 99 OTHER <br /> B. CONSTRUCTION A U 1 SINGLE WALLED AU 2 DOUBLE WALLED A U 3 LINED TRENCH A U 91 NONE A U 95 UNKNOWN A U 99 OTHER <br /> A U 1 STEEL/IRON A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC) A U 4 FIBERGLASS PIPE A U 91 NONE <br /> C. MATERIAL A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL CLADW/FRP A U 8 100%METHANOL COMPATIBLE FRP <br /> A U 9 GALVANIZED STEEL A U 95 UNKNOWN A U 99 OTHER <br /> V. LEAK DETECTION SYSTEM CIRCLE P FOR PRIMARY,OR S FOR SECONDARY,A PRIMARY LEAK DETECTION SYSTEM MUST BE CIRCLED. <br /> �J P S 1 VISUAL CHECK P S 2 INVENTORY RECONCILIATION P S 3 VADOSE WELL P S 4 ELECTRONIC MONITOR P S 5 GROUND WATER MONITORING WELLS <br /> P S 6 PRECISION TESTING P S 7 PRESSURE TESTING P S 91 NONE P S 95 UNKNOWN P S 99 OTHER <br /> VI. INFORMATION ON TANK PERMANENTLY CLOSED IN PLACE <br /> 1. ESTIMATED DATE LAST USED(MO/YR) 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH <br /> SUBSTANCE REMAINING IN GALLONS INERT MATERIAL? ❑ YES ❑ NO <br /> THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY,AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT. <br /> APPLICANT'S NAME(PRINTED&SIGNATURE) DATE <br /> LOCAL AGENCY USE ONLY <br /> COUNTY# JURISDICTION# AGENCY# FACILITY ID# TANK ID# <br /> Qo1 g S 0 �T7 5-F9-I I E I Fl- I <br /> 1- <br /> CURRENT LOCAL AGENCY FACILITY ID# APPROVED BY NAME PHONE#WITH AREA CODE <br /> a al1,35 <br /> PERMIT NUMBER PERMIT APPROVAL DATE PERMIT EXPIRATION DATE Q <br /> 43 <br /> rG/- o <br /> FRMB(6-29-88) <br /> K# PERMIT AMOUNT SURCHARGE AMT. FEE CODE RECEIPT# BY:r � it, — I "loe 5 <br /> ` THIS FORM MUST BE ACCOMPANIED BY A FACILITY/SITE APPLICATION, FORM 'A',UNLESS A CURRENT FORM'A' HAS BEEN FILED <br /> DATA PROCESSING COPY �\ <br />
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