BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

IFIED PROGRAM CONSOLIDATED FO TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page= TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE ❑ 7 PERMANENTLY CLOSED ON SITE (Check one item only) ❑ 3 RENEWAL PERMIT (Specify reason-for local use only) (Specify reason-for local use only) ® 8 TANK REMOVED 430 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Busnes is A3 S) FACILITY ID: Tosco#256981-Pacific 76 491 LOCATION WITHIN SITE(optional) South side Ott 4707 Pacific Avenue & March Lane, STOCKTON I:TANK DESCRIPTION (A scaled plot.plan withinIUC LlUn of the UST system including buildings.and landmarks shall be submitted to the local agency.) TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes NO a3a 2 Modern WeldingIf'Yes",complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1988 1 12,000 43e ADDITIONAL DESCRIPTION(For local use only) It.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ®1. MOTOR VEHICLE FUEL [:Ila. REGULAR UNLEADED ❑2. LEADED []5. JET FUEL (If marked complete Petroleum Type) 01b. PREMIUMUNLEADED 03. DIESEL 06. AVIATION FUEL ❑2. NON-FUEL PETROLEUM []lc. MIDGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER 3. CHEMICAL PRODUCT ry page) 441 CAS#(from Hazardous Materials Inventory page) 442 ❑ COMMON NAME (from Hazardous Materials Invento a e ❑4. HAZARDOUS WASTE (Includes Used 011) ❑95.UNKNOWN III. TANK CONSTRUCTION M 443 TYPE OF TANK ❑1. SINGLE WALL ❑3.SINGLE WALL WITH ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTE (Check one Item only) EXTERIOR MEMBRANE LINER El 95. UNKNOWN ®2. DOUBLE WALL []4. SIGNLE WALL IN VAULT ❑99. OTHER TANK MATERIAL-primary tank ❑1. BARE STEEL El 3, FIBERGLASS/PLASTIC [15. CONCRETE [195. UNKNOWN 444 (Check one item only) ❑2. STAINLESS STEEL 04. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/ ❑99.OTHER REINFORCED PLASTIC(FRP) 100%METHANOL TANK MATERIAL-secundarytank [11. BARE STEEL [13, FIBERGLASS/PLASTIC ❑5. CONCRETE ❑95. UNKNOWN 445 (Check one item only) ❑2. STAINLESS STEEL 0 4.STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE [199.OTHER REINFORCED PLASTIC(FRP) W/100h METHANOL ❑5. CONCRETE [110.COATED STEEL TANK INTERIOR LINING ❑7.RUBBER LINED ❑3.EPDXY LINING [15.GLASS LINING ❑95.UNKNOWN 446 DATEINSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99 OTHER (Far local use only) (Check one item only) 44e DATEINSTALLED 449 OTHER CORROSION ❑1 MANUFACTURED CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER (Check one item only) ❑2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(Iocal use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all ®1 SPILL CONTAINMENT 1988 ❑1 ALARM ❑3 FILL TUBE SHUT OFF VALVE that apply) - ®2 DROP TUBE 1988 ❑2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE1988 IV.TANK LEAK DETECTION(A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK(Check an that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(Ml ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ®2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE-IN PLACE 455 ESTIMATED QUANTITY OF SUBSTANCE 456 457 ESTIMATED DATE LAST USED(YR/MO/DAY) REMAINING TANK FILLED WITH INERT MATERIAL? 3/2000 0 gallons ❑Yes ® No Form B UPCF (1/99 revised) • Formerly Still