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csi <br /> WASTE OIL "' STATE OF CAUFORMA VolSTATE WATER RESOURCES CONTROL BOARDUNDERGROUND STORAGE TANK PERMIT APPLICATION . FORM B <br /> COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. <br /> c O RENEWAL PERMIT i 5 CHANGE OF INFORMATION L 7 PERMANENTLY CLOSED 0. SITE <br /> MARK ONLY t NEW PERMIT <br /> ONEITEM r,=l 2 INTERIM PERMIT 4 AMENDED PERMIT ��, 6 TEMPORARY TANK CLOSURE C 8 TANK REMOVED <br /> DBA OR FACILITY NAME WHERE TANK IS INSTALLED: 2526- W. Washington St. , Stockton, CA 95203 <br /> 1. 7ANKDESCRIPTION COMPLETEALLITEMS- SPECIFYIFUNKNOWN S. MANUFACTURED BY: Modern Welding Co-STI-P3 <br /> A. OWNER'S TANK I.O.s UL#5-3516455TI-P3 #7946 <br /> D. TANK CAPACITY IN GALLONS: 1,000 <br /> C. DATE INSTALLED(MCIDAY/YEAR) ]_111/57 <br /> ILTANKCONTENTS IF Aa IS MARKED,COMPLETE ITEM C. C aREGULAR 3 DIESEL 6AVIATION GAS <br /> 1 MOTOR VEHICLE FUEL � a OIL 0. I UNLEADED 71 a GASAHOL <br /> A. 1 PRODUCT J 10 PREMIUM 7 METHANOL <br /> 2 PETRCLE'JM 80 EMPTY ❑ UNLEADEE7 77 5 AETFUEL <br /> 3 CHEMICALPROOUCT O 95 UNKNOWN rr 2 WASTE i 2 LEADED $I 99 OTHER (DESCRIBE IN ITEM D. BELOW <br /> IF(A.1)IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED Waste Oil <br /> C.A.S.s: N/A <br /> III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A.B.AND C.AND ALLHAT AP-LIES INBOX0 <br /> 1 DOUBLE <br /> WALL I� 3 SINGLE WALL WITH EXTERIOR LINER 95 UNKNOWN <br /> A. TYPE OF '� F7 A SECONDARY CONTAINMENT (VAUL 20 TANKI ',_ 99 OTHER <br /> SYSTEM ' 2 SINGLE WALL <br /> �i� t BARE STEEL 2 STAINLESS STEEL 3 P SEEE;G'LASS 4 STEEL CLAD WI FIBERGLASS RENFORC'ED PLASTIC <br /> S. TANK 6 POLYVINYL CHLORIDE 7 ALUMINUM 8 100. METHANOL COMPATIBLE WIFRP <br /> MATERIAL S cDNCRETE <br /> (Primary Tank) r. 9 BRONZE 10 GALVANIZED STE-'_ 95 UNKNOWN 99 OTHER <br /> 1 RUBBER LINED 2 ALKYD LNING 3 EPDXY LINING 4 PHENCLIC LINING <br /> C.INTERIOR 5 GLASS LINING 6 UNLINED �'� 95 UNKNOWN 99 OTHER <br /> UNING — <br /> IS LINING MATERIAL COMPATIBLE WITH 1Q METHANOL? YES_ NO <br /> CORROSION 1 POLYETHYLENE WRAP 2 COATING 1= 3 VINYL WRAP -' 4 FIBERGLASS REINFORCED PLASTIC <br /> D.COR � <br /> PROTECTION � 5 CATHODIC PROTECTION 91 NONE 95 UNKNOWN 99 OTHER <br /> IV.PIPING INFORMATION CIRC'.- A IF ABOVE GROUND OR U IF UNOEBGROUNO.BOTH IF AP LICABLE <br /> =MATERIAL <br /> E A U 1 SUCTION A U 2 PRESSURE AOU 3 GRAVITY A U 99 OTHER <br /> CONSTRUCTION A�U t SINGLE WALL A U 2 DOUBLE WALL A U 3 LIN-c0 TRE`ICH 4 U 95 UNKNOWN p U 99 OTHER <br /> AND A U t BARE-STE=_L A U 2 STAINLESS STE? A U 3 POLYVINYL CHLORIDE�PVMA U 4 FIBERGLASS PIPE <br /> N A U 5 ALUMINUM A U 6 CONCREE7E A U 7 STEELWICOATING A U 8 100. MEE THANOL COMPATIBLE NFRPN A U 9 GALVANIZED STEEL A©10 CATHODICPROTECTION A U 95 UNKNOWN A U 99 OTHER <br /> 1 AUTOMATIC LINE L-AK DETECT.R 2 LINE TIGHTNESS TESTING "WNRCRMG99 OT'-RECTION ` � �-� <br /> V.TANK LEAK DETECTION _ <br /> FL= 61 <br /> SUALCHECK 2 INVENTORY RECONCILIATION 3 VAPOR MONITORING 4 AUTOMATIC TANK GAUGING 5 GR <br /> OUNC WALTER MCNITOPING <br /> NK TESTING LX, 7 INTERSTITIAL MONITORING �� 91 NONE ! 95 UNKNOWN 99 OTHER <br /> VI.TANK CLOSURE INFORMATION <br /> .EST]MATED DATE LAST USED(MO/OAYNRI 2.ESTIMATED QUANTITY OF 3,WAS TANK FILLED WITH YES NO <br /> SUBSTANCE REMAINING GALLONS INERT MATERIAL <br /> THIS FORM HAS BEEN COMPLETED I1-uTER PENALTY 0) J Y,A TO THE MY KNOWLEDGE, IS TRUE AND COARECT' <br /> APPLICANTS NAME GATE <br /> IPaNTE0841GN41UFE1 Richard A. Recor 10/02/92 <br /> LOCAL AGENCY USE ONLY THE STATE I.D.NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW <br /> CO�UN�TY#� JURISDICTION# FACILITY# TANK it n�I <br /> STATE I.D. 'V.v <br /> PERMIT NUMBER PERMIT APPROVED SYIDATE PERMIT EXPIRATION OATS <br /> FORMS (9.901 THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION-FORM A.UNLESS A CURRENT FORM A HAS BEENFIL . <br /> SAA <br />