BILLING_2002-2011 - Laserfiche WebLink

Home Browse Search

IED PROGRAM CONSOLIDATED FORM TANK: TA0515639 PRN: PR0231595 a, UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC #: FA0003591 (two pages per tank) TYPE OF ACTIONPage 6 of 7 ❑INEW SITE PERMIT ❑4AMENDED PERMIT [�SCHANGE OF INFORMATION ❑bTEMPORARY SITE CLOSURE 1$ 1 1/ (Check .1,item ooly) - 'E+ El7 PERMANENTLY CLOSED ON SITE (8pKify f«focdpac Duly)) (Spcwa maaw ❑STANK REMOVED ❑ 3RENEWAL PERMIT 430 BUSINESS NAME (S. as FACILITY NAME « DBA -Doing a«iocsa As) FACILITY ID'. PR#: LINDEN MARKET 3 FA0003591 PR0231595 LOCATION WITHIN SITE (optlwd) 8203 E HWY 26, STOCKTON 431 PHONE / 1. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks Sball be submitted to the local agency.) TAMC ID# Tank #: 6 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ® yes ❑ No 434 TA0515639 MODERN WELDING v^Ye,wmpkwwepager e«hcanparuxnt. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUP.IDER OF COMPARTMENTS 437 $ 000 2 ADDITIONAL DESCRIPTION (F« wad aac w y) 438 H. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® I. MOTOR VEHICLE FUEL ❑ Ia. REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL (Ifm dw p[e Pe Ie Type) ❑ 1b. PREMIUM UNLEADED M 3. DIESEL ❑ 6. AVIATIONFUEL ❑ 2. NON -FUEL PETROLEUM ❑ Ic. MIDGRADE UNLEADED ❑ 4. GASOHOL ❑ 99. OTHER ❑ 3. CHEMICAL PRODUCT COMMON NAME(aom Hoard Mawials lnvcn« page) qH CAS#(Gan Hazudws Mnaaiala warntoo page) 442 ❑ 4. HAZARDOUS WASTE Omludna Uxd On DIESEL #2 68476-34-6 ❑ 95. UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK ❑ I. SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Checkac item wN) EXTERIOR MEMBRANE LINER ❑ 95. UNKNOWN ® 2. DOUBLE WALL ❑ 4. SINGLE WALL IN VAULT ❑ W. OTHER TANK MATERIA. - primary tank ❑ I. BARE STEEL ❑ FIBERGLASS / PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN 444 (Chat.Iwn wry) ❑ 2. STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8. FRP COMPTIBLE W/ IOP/a METHANOL REINFORCED PLASTIC (FRP) ❑ 99. OTHER TANK MATERIAL -secondary tank ❑ 1, HARE STEEL ❑ 3. FIBERGLASS/PLASTIC ❑ 5. CONCRETE [:195. UNKNOWN 445 (Cheat weitemwty) ❑ 2. STAINLESS STEEL ® 4. STEEL CLAD WTHIERGLASS ❑ & FRP COMPTIBLE Wit 00% METHANOL REINFORCED PLASTIC (FRP) ❑ I0, COATED STEEL ❑ 99. OTHER ❑ 5. CONCRETE TANK INTERIOR LINING ❑ L RUBBER LINED ❑ 3. EPDXY LINING ❑ 5. GLASS LINING ❑ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING (Cb%k we Ilan wly) ❑ 2ALKYD LINING ❑ 4PHENOLIC LINING ® 6UNLINED [3OTHER -(F«local «e a0y) OTHERCORROSION ❑ I MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN "S DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION F-1(Chmkwelwmwly) OIMPRESSED CURRENT El990THER ❑ 25ACRIFlCIAL ANODE (F«I«el uee wty) SPILL AND OVERFILL YEARMSTALLE450 TYPE(1=1=wty) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Gh k all Uel VPIH ® I SPILL CONTAINMENT 2,002.00 PHILTITE ® I ALARM 2,002.00 ❑ 3 FILL TUBE SHUT OFF VAL` ❑Y 2 DROP TUBE 2,002.00 OP) ® 2 BALL 2,002.00 ❑ 4 EXEMPT ❑X 3 STRIKER PLATE 2,002.00 UNI FLOAT IV. TANK LEAK DETECTION (A dea«ipuun ohne mo 4l 9 prapram shall h mbmdwd w the local egwry.) IF SINGLE WALL TANK (Check 01 0,41 apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL (EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chwkawltanwb) ❑ 1 VISUAL (SINGLE WALL IN VAULT ONLY) ❑ 2 AUTOMATIC TANK GAUGING (ATG) ❑ 6 VADOSE 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 E:]Yes ® No UPCF (12/99 revised)