BILLING 1994-2009 (2) - Laserfiche WebLink

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' FIED PROGRAM CONSOLIDATED FORM IANK: TA05048 6 PR#: PR0231482 UNDERGROUND STORAGE TANKS - TANK PAGE FAC#: FA0000720 (tw pages per tank) TYPE OF ACTION 6 ❑ 1NEW SITE PERMIT ❑ YAMENDED PERMIT ❑ SCHANGE OF ❑ 6TEMPORARY SITE RE (CTck oNy ilan oily) ❑ ]PERMANENTLY CLOSED O SITE (Specify 6rItcu cpoly) (Spcity.-PnI.I.sey). 3 RENEWAL PERMIT FAIeTANK REMOVED �'Q o BUSINESS NAME(Sanw as FACILITY NAME w DBA-Doing Business As) FACILCIY ID: PR tt: MADSEN'S SUNRISE DAIRY 3 FA0000720 PR0231482 LOCATION WITHIN SITE(Opdana0 239 S STOCKTON ST,RIPON 431 PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANKIDN Tank#: 6 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK Yes ❑No 434 TA0504846 MODERN WELDING CO IVY.'.wmPlne P.V Tweseh(ssnpmeeen. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 -{ 2,632 ADDITIONAL DESCRIPTION(Fwlow ue oey) 438 D.TANK CONTENTS TANK USE 4J9 PETROLEUM TYPE uo ® I.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑5.JET FUEL QOsmItWwWletc Pclmlemn Type) ❑ Ib.PREMIUM UNLEADED ® 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ It.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(rwn lara,dnw Mmcials leuwmtypage) 441 CAS#(wm page) 442 ❑4.HAZARDOUS WASTE Ovaam Used a0 ❑95.UNKNOWN M.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑3.SINGLE WALL WITH ❑5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Cackom man ony) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ®2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIA.-priamy tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (Click ow new may) ❑ 2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/TOO%METHANOL REINFORCED PLASTIC(I") ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chale am I=only) ❑ 2.STAINLESS STEEL �C$.STEEL CLAD W/FIBERGLASS ❑ I.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ MOTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ I.RUBBER LINED ❑ 3.EPDXY LINING447 OR COATING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED (Click one it=only) ❑2ALKYD LINING ❑4PHENOLIC LINING ® 6UNLINED ❑99.OTHER (PwbW use wly) OTFERCORROSION ❑ I MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN -8 DATEINSTALLED a9 PROTECTION IF APPLICABLE PROTECTION (C kwwaemunly) ❑4 IMPRESSED CURRENT ❑ 99 OTHER F1 25ACRIFICIAL ANODE (Pwloul wcany) SPILL AND OVERFILLYEARYEAR INSTALLE450 TYPE(Iwduseony) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 Cas ( k all mat appy) V1) I SPILL CONTAINMENT �� ❑ IALARM X3FILLTUBESHUTOFFVAL`�� K.2 DROP TUBE ❑ 2 BALL �r ❑4 EXEMPT 2}3 STRIKER PLATE FLOAT rV.TANK LEAK DETECTION(A aucptioner atc coNmrmq wo4am aan b sw iummm 11agwny.) IF SINGLE WALL TANK(Clek an ast mply) 453 IF DOUBLE WALL TANK ORTANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chck..i oely) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG [-17 GROUNDWATER ® 2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING (SIR)BIENNIAL TANK TESTING ❑3 MANUAL MONITORING F1 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 ❑Yes ❑No UPCF(12/99 revised)