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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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N
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NEWTON
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4350
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2300 - Underground Storage Tank Program
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PR0503337
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BILLING
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Entry Properties
Last modified
11/6/2020 12:44:21 PM
Creation date
11/5/2018 9:56:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
RECORD_ID
PR0503337
PE
2381
FACILITY_ID
FA0005791
FACILITY_NAME
SPEARS MANUFACTURING
STREET_NUMBER
4350
Direction
N
STREET_NAME
NEWTON
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
4350 N NEWTON RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\N\NEWTON\4350\PR0503337\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
11/3/2017 7:53:23 PM
QuestysRecordID
3717047
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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STATE OF CALIFORNIik WATER RESOURCES CONTRVOARD ;.` '•. <br /> FORM 'B': UNDE GROUND STORAGE TANK PROGRAM <br /> TANK TANK PERMIT APPLICATION INFORMATION ® <br /> COMPLETE A SEPARATE FORM WITH THE FOLLOWING NFORMATION FOR EACH TANK. - - 7`, <br /> 7 <br /> MARK ONLY ❑ 1 NEW PERMIT ❑3 RENEWAL PERMIT EJ5 CHANGE OF INFORMATION ❑ 7 PERMANENTLY CLOSED T <br /> ONE ITEM ❑ 2 INTERIM PERMIT ❑ 4 AMENDED PERMIT ❑ 6 TEMPORARY TANK CLOSURE ❑8 TANK REMOVED a-- <br /> FACILITY/SITE NAME WHERE TANK IS INSTALLED: i FARM TANK-YES❑ NO N <br /> C7) <br /> I. TANK DESCRIPTION COMPLETE ALL ITEMS-IF UNKNOWN–SO SPECIFY Q <br /> A. OWNERS TANK ID# I I B. MANUFACTURED BY: �. c::) <br /> C. YEAR INSTALLED � 0. TANK CAPACITY IN GALLONS: <br /> II. TANK C NTENTS IF(A.1),IS MARKED,COMPLETE ITEM C.IF(A.1),IS NOT MARKED,SOMPLETE ITEM <br /> A. 1 MOTOR VEHICLE FUEL ❑ 2 PETROLEUMB C. 1 UNLEADED 2 LEADED ❑ 3 DIESEL <br /> F--] 3 CHEMICAL PRODUCT ❑ 4 OIL PRODUCT ❑ 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 <br /> HAZARDOUS SUBSTANCE STORED&C.A.S.# C.A.S.#: <br /> III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOX A,B,C.A D <br /> A.TYPE OF ❑ 1 DOUBLEWALLED ❑ 3 SINGLE WALLED WITH EXTERIOR LINER ❑ 95 UNKNOWN <br /> SYSTEMSINGLE WALLED ❑ 4 SECONDARY CONTAINMENT ❑ 99 OTHER <br /> EEUIRON ❑2 STAINLESS STEEL ❑ 3 FIBERGLASS ❑ 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC <br /> B.TANK ❑5 CONCRETE ❑ 6 POLYVINYLCHLORIDE ❑ 7 ALUMINUM ❑ 8100%METHANOL COMPATIBLE FRP <br /> MATERIAL <br /> ❑ 9 BRONZE ❑ 10 GALVANIZED STEEL ❑ 95 UNKNOWN ❑ 99 OTHER <br /> ❑ 1 RUBBER LINED ❑ 2 ALKYD LINING ❑ 3 EPDXY LINING ❑ 4 PHENOLIC LINING <br /> C. INTERIOR <br /> F–] F–]LINING 5 GLASS LINING 6 UNLINED UNKNOWN <br /> ❑ IS LINING MATERIAL COMPATIBLE WITH 100%METHANOL? ❑YES yI❑ NO ❑ 99 OTHER <br /> D. CORROSION ❑ 1 POLYETHLENEWRAP ❑2 TAR OR ASPHALT ❑ 3 VINYL RAP ❑ 4 FIBERGLASS REINFORCED PLASTIC <br /> PROTECTION ❑ 5 CATHODIC PROTECTION ❑ 91 NONE IL{—�I KNOWN ❑ 99 OTHER <br /> IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND, U IF UNDERGROUND,BOTH IF APPLICABLE <br /> A. SYSTEM TYPE A SUCTION A U 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 A U 2 DOUBLE WALLED A U 3 LINED TRENCH A U 91 NONE A U 95 UNKNOWN A U 99 OTHER <br /> AQ 1 STEEL/IRON A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC) A U 4 FIBERGLASSPIPE A U 91 NONE <br /> C. MATERIAL A 5 ALUMINUM A U 6 CONCRETE A U ] STEEL CLAD W/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 /> P S iVISUAL CHECK P S 21NVENTORV RECONCILIATION P S SE WELLS P S 4ELECTRONICMONITOR P S 5 GROUNDWATER MONITORING WELLS <br /> P S 6 PRECISION TESTING P S ] PRESSURE TESTING P S 91 NONE P S 95 UNKNOWN P S 99 OTHER <br /> VI. INFORMATION ON TANK PERMANENTLY CLOSED IN PLACE <br /> L 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# FAC ILI TANK ID# <br /> CURRENT LOCAL FACILITY ID N APPROVED BY NAME ] PHONE N WITH AREA CODE <br /> o Qa Y �- <br /> PERMIT NU BER PEflM1T APPROVAL DATE PERMIT fXPIRATION DATE <br /> \ CHECKN PERMIT AMOUNT SURCHARGE AMT. FEE CODE RECEIPTBY: <br /> ,v,1VfI FORM B(6-29-88) THIS FORM MUST BE ACCOMPANTWA FACILITY/SITE APPLICATION, FORM 'A',UNLESS A MRENT FORMA' HAS BEEN FILED <br /> DATA PROCESSING COPY <br />
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