BILLING_2002-2011 - Laserfiche WebLink

Home Browse Search

{ IED PROGRAM CONSOLIDATED FORM TANK: TA0515637 PR #: PR0231595 UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC #: FA0003591 (two pages per tank) Page 2 of7 TYPEOFACTION ❑ INEW SITE PERMIT ❑ 4AMENDED PERMIT 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE 1 (Ch«k «ly loan only) - - 7 PERMANENTLY CLOSED ON SITEI (Span u.-fmlocd asa edYl l51 f. msson �f I«Iuac oaM1) ❑STANK REMOVED 4 ❑ 3RENEWAL PERMIT BUSINESS NAME (S. a a FACILITYNAME m DBA - Doing Busin•ssw FACILITY II). PR #: LINDEN MARKET FA0003591 PR0231595 LOCATION W1 EUN SITE(01h.•0 8203 E HWY 26, STOCKTON n \ 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 43z TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑ Yes ® No 434 TA0515637 MODERN WELDING If"Yw", wmple¢a«page f«weh wmpam«m. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 10,000 1 ADDITIONAL DESCRIPTION (F« tical aae oay) 438 Il. TANK CONTENTS TANK USE 439 PETROLEUM TYPE a4p ® 1. MOTOR VEHICLE FUEL M la. REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL (Ifmmkw.Plme Pcuoleom Type) ❑ Ib.PREMIUMUNLEADED ❑ 3. DIESEL ❑ 6. AVIATION FUEL ❑ 2. NON -FUEL PETROLEUM ❑ Ic MIDGRADE UNLEADED ❑ 4. GASOHOL ❑ 99. OTHER ❑ 3. CHEMICAL PRODUCT COMMON NAME (Gom xaardma Mataials mvmlory p•ge) 441 CAS# (t Haamdmm Maacrials m�. Page) 442 ❑ 4. HAZARDOUS WASTE $'] GASOLINE 8006-61-9 (Wl U«ae3) ❑ 95. UNKNOWN HL TANK CONSTRUCTION TYPE OF TANK ❑ I. SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 EXTERIOR MEMBRANE LINER El 95. UNKNOWN (CM1ecka«pan w�N) ® 2. DOUBLE WALL ❑ 4. SINGLE WALL IN VAULT ❑ 99. OTHER TANK MATERIAL -primary tank ❑ I. BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN 444 (Chxka« iaem oan) ❑ 2. STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8. FRP COMPTIBLE W/ 100% METHANOL REINFORCED PLASTIC (FRP) ❑ 99. OTHER TANK MATERIAL - secondary tank ❑ I. BARE STEEL ❑ 3. FIBERGLASS/ PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN 445 (Ch«k om ilemad5') ❑ 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 ❑ ],RUBBER LINED ❑ 3. EPDXY LINING ❑ 5. GLASS LINING ❑ 95. UNKNOWN 446 DATE INSTALLED ORCOATING ❑ 99, OTHER (Cb koaeitemonly) r_12ALKYDUNING ❑ 4PHENOLIC LINING ® 6UNLINED (Fork .only) 449 OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION ❑ 41MPRESSED CURRENT ❑ 99 OTHER (Ck kmrilemanly) ❑ 2 SACRIFICIAL ANODE (For[.. use Dory) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(I«aluaeoaly) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 ® I SPILL CONTAINMENT 2,002.00 PHILTITE ®IALARM 2,002.00 ❑ 3 FILL TUBE SHUT OFF VAU (Chack all not apply) Q 2 DROP TUBE 2,002.00 OP W ® 2 BALL 2,002.00 ❑ 4 EXEMPT 0 3 STRIKER PLATE 2,002.00 UNK FLOAT W. TANK LEAK DETECTION(A4e•miption.fm•.aa."pmmamandl l,e mmm�wmmal«dae y.) IF SINGLE WALL TANKTC k all Wt apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL (EXPOSED PORTION ONLY) ❑ S MANUAL TANK GAUGING(MTG) (Chmk mm im only) ❑ I VISUAL (SINGLE WALL IN VAULT ONLY) ❑ 2 AUTOMATIC TANK GAUGING (ATG) ❑ b NODOSE ZONE ❑ 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.? 457 ❑ Yes ® No UPCF (12/99 revised) 31v('f