BILLING 1994-2009 (2) - Laserfiche WebLink

Home Browse Search

I f ni r IFIED PROGRAM CONSOLIDATED FORMTANK: TAo 04844 (-Dem /6, PR#: PR0231482 UNDERGROUND STORAGE TANKS -TANK PAGE FAC#: FA0000720 (twoages ertank) e2af7 TYPE OF ACTION ❑ INEW SITE PERMIT ❑ 4AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 61MrOX16YSITE CLOSURE (CFack arty imn only) -. nh. 34 "'"i, ❑ 7 PERMANENTLY CLOSED ON S (Spmbrmsw fm I..)auoaly) (S 3RENEWAL PERMIT ' BTANK REMOVED 8 J5- D BUSINESS NAME(S2=0 FACILITYNAMEmNA.Doing Business A,) FACILITYID: PR#: l MADSEN'S SUNRISE DAIRY FA0000720 PR0231482 0 LOCATION WITHIN SITE(oni.h 239 S STOCKTON ST,RIPON .� f 431 PHONE I.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#: 4 432 TANK MANUF CTURER431 COMPARTMENTALIZED TAMC yes El No 434 TA0504844 0 .Q,l`fJ N1e1Dln Cv; If"Yw",w�Ige one pag fineachmegv,mmL DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY fN GALLONS 416 NUMBER OF COMPARTMENTS n 437 0 ` 2 632 5 ADDITIONAL DESCRIP ON(Fm loud me awy) 439 H.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® I.MOTOR VEHICLE FUEL 45.18.REGULAR UNLEADED [-12.LEADED ❑ 5.JET FUEL L f toukd wmplete Pelmlc=Type) Ib.PREMIUM UNLEADED [-13.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(Oom Harardoiu Malmiab lmwlmypagc) 441 CAS#(rmm HOamdmea Materiab lmemmy page) E-14.HAZARDOUS WASTE a2 ftmeet Used Oil) ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check arc item only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WAIL ❑4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary unk ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (Chakaro iwn oNy) ❑ 2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑99 OTHER TANK MATERIAL-secondary,lank ❑ L BARE STEEL ❑3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 (Click mei,wn may) ❑ 2.STAINLESS STEEL 4.STEEL CLAD WNIBERGLASS ❑ 8.PEP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 147 OR COATING (Click om i..*) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ® 6 UNLINED ❑ 99.OTHER (Fmbnl useonb) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ®3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 449 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Chckmmiutnonly) E]41MPRESSEDCURRENT El 99 OTHER ❑ 2SACRIFICIAL ANODE (Pm brat ive only) SPILL AND OVERFILL YEAR YEAR INSTALLE450 TYPE(b 1,ecmly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR MSTALLED QQNV 452 PC kAldulapply) KL I SPILL CONTAINMENT 1,994.00 ❑ IALARM �3FB.L TUBE SHUT OFF VAL` _ �2 DROP TUBE I�Iy (,v AYInI ❑ 2BALL ❑4EXEMPT fA 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A d mption orme monitnringpm9mm alun b<:d,mined u debral it y.) IF SINGLE WALL TANK(Ch all Wm appy) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Checkonenen'only) ❑2AUTOMATIC TANK GAUGING(ATG) ❑fiVADOSE ZONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OFSUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 451 ❑ Yes ❑No UPCF(12/99 revised)