BILLING 2006 - 2008 - Laserfiche WebLink

Home Browse Search

UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION (One form per UST) TYPE OF ACTION (Check one item only. For a FIST closure or removal,complete only this section and Sections I,Il,II{IV,and LY below) ao. ® L NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430a I DATE EXISTING UST DISCOVERED: 4306. I. FACILITY INFORMATION FACILITY ID R(Agency Use Only) _ _ Q 11718 1 9 1. BUSINESS NAME(Same as Facility Name or DBA-Doing Business As) 3. GASSPECS, INC. dba GREAT AMERICAN GAS & CAR WASH BUSINESS SITE ADDRESS CITY 104. 2115 W. Yosemite Ave. Manteca II. TANK DESCRIPTION TANK ID 4 432. TANK MANUFACTURER 433. TANK CONFIGURATION:THIS TANK IS 434 3 Containment Solutions ❑ L A STAND-ALONE TANK cowlene one pasc for each ® 2.ONE INA COMPARTMENTEDUNIT conwxno,em.roe wit. DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS IN THE UNIT 437 2007/12 10,000 2 III. TANK USE AND CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ le.AVIATION FUELING 439_ ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(.eludes Used Oip [1 5.EMERGENCY GENERATOR FUEL p3SC§25281.5(.)] ❑ 6 OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑.99 OTHER(Specify). 439. . .-_....""-.. -.....N.L ....--...... _ CONTENTS PETROLEUM ❑ la.REGULAR UNLEADED ❑ Ic MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440. ® 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS 0,,.8:_PETROLEUM BLEND FUEL ❑ 9 OTHER.PETROLEUM(Spec fy): 440a ............. NON-PETROLEUM ❑ 7.USED OIL ❑ 10 ETHANOL ❑ 11.OTHER NON-PETROLEUM(Specify): 4406. IV. TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL_ _❑_95.UNKNOWN 443. PRIMARY CONTAINMENT ❑ L STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444. ❑ 7.STEEL+INTERNAL LINING .❑ 95 UNKNOWN ❑ 99 OTHER(Specify): 444. SECONDARY CONTAINMENT ❑ LSTEEL ®3 FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED -4 90. ❑ 95 UNKNOWN ❑99 OTHER(Specdy):, 445. OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT ® 3.FILL TUBE SHUT-OFF VALVE 452 ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 99.OTHER 460. SIMEM PRIMARY CONTAINMENT ❑ 1.STREELURE ® q FIBERGLASS ❑ S.FLO XIBLE`ONAL SUCTION O;0 R GID PLAO I.0 OCR fi263H---p 456 64 Q 90.NONE ❑ 95 UNKNOWN -95 OTHER,(Specify} 464. .._...._. ................. SECONDARY CONTAINMENT ❑ 1.STEEL ® 4 FIBERGLASS ❑ S FLEXIBLE ❑ !0.RIGID PLASTIC 4646. ❑,90:NONE [1 95.UNKNOWN ❑ 99.OTHER(Specify) 464c. PIPING/TURBINE CONTAINMENT SUMP TYPE ❑ 1 SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE 464d. VI. VENT,VAPOR RECOVERY (VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS060. ❑ 10 RIGID PLASTIC ❑ ....NONE ❑ ...OTHER-Specify): 464et VENT SECONDARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 4444 --_" ......_......- ............... .._.__..._ ..._....-....... ...-..."-- ...--...--...._ .. 4 fl.... VR PRIMARY CONTAINMENT ❑ L STEEL ® 4 FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 4&i'l_ VR SECONDARY CONTAINMENT ❑ 1.STEEL ® 4 FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): °�6kh ................. -. .._.-...------_ .......... _-.--..""-.. _ VENT PIPING TRANSITION SUMP TYPE ❑ t SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE 464i� RISER PRIMARY CONTAINMENT ® 1 STEEL ❑ 4 FIBERGLASS ❑,-10 RIGID PLASTIC ❑ 90 NONE ❑ 99.,OTHER(Specify): a6a4)j RISER SECONDARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 10 RIGID PLASTIC [I 90 NONE [I99.OTHER(Specify): 4"k]- FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATEBOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 451 c- VII. UNDER DISPENSER CONTAINMENT (UDC) CONSTRUCTION TYPE ❑ 1 SINGLE WALL ® 2 DOUBLE WALL 0 3.NO DISPENSERS ❑ 90.NONE 469. CONSTRUCTION MATERIAL ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 4696_ 469e. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODES ❑ 4.IMPRESSED CURRENT ® 6.ISOLATION 448 IX. APPLICANT SIGNATURE CERTIFICATION: I certify at is USTsy patible with the hazardous substance stored and that the information provided herein is true, accura din ull com is ith 1 al requirements. APPLICANT SIGNATURE N DATE 470 APPLICANT NAME(print) SYMVNIAHMED 471 ' APPLICANTTITLE VICe President 472.