BILLING 1994-2009 (2) - Laserfiche WebLink

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` FIED PROGRAM CONSOLIDATED FORMANK:TA05B4g45 PR#: PRO231482 UNDERGROUND STORAGE TANKS -TANK PAGE FAC#: FA0000720 (t o pages per tank) nge 4 of 7 TYPE OF ACTION ❑ INEW SITE PERMIT ❑ 4AMENDED PERMIT ❑ 5CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Clark only ha^only) '- 4 ❑ 7 PERMANENTLY CLO ON 1TE (Spemryomma-Tmlmalmeooly) 3 RENEWAL PERMIT � (Spen[ytv4m-fbrbulm<oNy): IK4 8TANK REMOVED 03 450 �/-� BUSINESS NAME(S3=m FAULITVNAMEmDBA-Done Bmimas As) FACILITY ID: PR#: 'L ' MADSEN'S SUNRISE DAIRY FA0000720 PR0231482 LL LOCATION WITHIN SITE(opsiman 239 S STOCKTON ST,RIPON 1 451 PHONE �99 31)ks 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be subrmtted to the local agency.) TANK ID# Tank#: 5 452 TANK MANUFACTURER411 COMPARTMENTALIZED TANK Ip Yes E]No 434 TA0504845 MODERN WELDING CO R•re.<mnplac<nep.a<rtr a *omparmen DATE INSTALLED(YEAR/MO) 455 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS ^ 437 (-7 - 41 Ll 6,768 S ADDITIONAL DESCRIPTION(Fmloml me only) 438 O.TANK CONTENTS TANKUSE 439 PETROLEUM TYPE "a M L MOTOR VEHICLE FUEL ® I.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL prmatkedm�ldc pcnoMm Tyyc) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑b.AVIATION FUEL ❑2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(6mn Hanmd<m Mareiah lmmto, W) MI CAS#(awn H=oseas Matente lnvcmory page) 442 ❑4.HAZARDOUS WASTE (Imlwes Wait On) ❑ 95.UNKNOWN M.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chink om l=envy) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIAL-primary rank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑5.CONCRETE ❑ 95.UNKNOWN 444 (Cluck mu iraNy) ❑2.STAINLESS STEEL in STEEL CLAD W/FIBERGLASS ❑8.FRP COMPTIBLE W/100-A METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑3.FIBERGLASS/PLASTIC ❑ S.CONCRETE ❑ 95.UNKNOWN 445 (Ctcckom imn mty) ❑ 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 ❑3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING (Chmkwn 0mi only) ❑ 2 ALKYD LINING E]4 PHENOLIC LINING ®b UNLINED -] 99.DTHER (Fmloml me mJy) OTHERCORROSION ❑ I MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC E] 95 UNKNOWN 448 DATEMSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Cherkmehanoeb) ❑ 4IMPRESSED CURRENT E] 99OTHER ❑25ACRIFICIAL ANODE (Pmlmlme mly) SPILL AND OVERFILL YEAR INSTALLE450 TYPEomalmecob) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 1 SPILL CONTAINMENT o1r7H M 4D( ((luck all Jut apply) ElI ALARM �k 3 FILL TUBE SHUT OFF VAL` DROP TUBE 7'a qOIS � a E] 2 BALL E] 4 EXEMPT STRIKERPLATE FLOAT TV.TANK LEAK DETECTION(A a cription offs mmiwro,pro,rene still beenbminea w Ju lural a,ce,) IF SINGLE WALL TANK(Ctwh all Jut apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chea min=orly) ❑2AUTOMATIC TANK GAUGING INTO) ❑ b 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 ❑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 OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 45t ❑Yes ❑ No UPCF(12/99 revised)