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pk 7 FIED PROGRAM CONSOLIDATED FORM TANK: TA0234801 AelPR#: PR0232348 UNDERGROUND STORAGE TANKS -TANK PAGE 1 FAC#: FA0003944 (two pages per tank) Page 2*f3 TYPE OF ACTION ❑ 1 NEW SI I L PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE.OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Clxskonly non only) ❑ 7 PERMANENTLY CLOSED ON SITE (Spa son for ldcdusc QnE) Ispaiyreu.-rad.]...rl}) F-1 3RENEWAL PERMIT ;'. ❑STANK REMOVED 436 BUSINESS NAME(svrcuFACILITYNAMEor DBA-Doing Basincss as) FACILITY'IU: PR;I: I ROBINSON TRUCKING FA0003944 PR0232348 LOCATION WITHIN SITE(Opdwap 11180 S VALLEJO CT,FRENCH CAMP 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.) TANK ID# Tank#: 1 432 TANK MANUFACTURER 413 1COMPARTMENTALIZED TANK Dyes ❑No 434 TA0234801 TRUSCO TANK v^ve:mamm.aempage ror men caaParmemc DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 416 NUMBER OF COMPARTMENTS 437 1/1/1988 12,000 ADDITIONAL DESCRIPTION(For local me only) 438 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® L MOTOR VEHICLE FUEL ❑ Ia.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Ifmarked coWlmc Pcaelcum Type) ❑ Ib.PREMIUM UNLEADED 99 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(fmm Ha us Mmmials beamrorywsc) MI CAS#(Bam llmoIDus Mamiiab hrvmlmy page) 442 ❑4.HAZARDOUS WASTE (Iadudn Usad Od) ❑95.UNRNOWN IH.TANK CONSTRUCTION TYPE OF TANK ❑ L SINGLE WALL ❑ 3.SNGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Click mm item only) EXTERIOR MEMBRANE LINER [-195.UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (Cbak om it m only) ❑ 2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(I") ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Cheek one itcrn only) ❑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 ❑ L RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED N7 OR COATING ❑ 99OT}83R (C'rerk one hen only) ❑ 2ALKYD LINING ❑ N . 4PHENOLIC LINING ® 6UNL ED (For weal me only) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ®3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Chn irenonly) ❑ 4 IMPRESSED CURRENT El 99 OTHER F1 2SACRIFICW.ANODE (Porloral uconly) SPILLANDOVERFILL YEAR MSTALLE450 TYPE(localusconly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (CM1 k aB dca apply) ❑ I SPILL CONTAINMENT ❑ I ALARM ❑ 3 FILL TUBE SHUT OFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑ 4 EXEMPT ❑ 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A descttion afore mmdmdng Martin shall bcsubrnlnad to dee local agency) IF SINGLE WAW..TANK(CImIc all dear appy) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Cbck one ncm ody) ❑ 2AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ❑2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK 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 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH VERT MATERIAL? 457 O I 0 ❑Yes ❑ No UPCF(12/99 revised)