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D PROGRAM CONSOLIDATED FORM,.W <br /> TANKS <br /> UNDERGROUND STORAGE TANKS -TANK PAGE 1 <br /> (tee Pea Pe<w ) � <br /> TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT JU 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE <br /> (Cheer mm ihm mh) ❑ ? PERMANENTLY CLOSED ON SITE <br /> ❑ 3 RENEWAL PERMIT (Spnfy.eem-fminni. y) (sne�Nr"am-fmloml�emly) ❑ 9 TANK REMOVED <br /> BUSINESS NAME(s®e u FACILITY NAME O.DTA-oFACILITY ID. 1 <br /> ,an Toa tbt Ke iordL Tran IT D'Sin'Lt Cl �1,y <br /> LOCATION WITHIN SITE(opo0.9 <br /> 1J <br /> L TANK DESCRIPTION (A slslcd plot plan with the location of the UST system including buildings and IandlRarks shall be wbmittcd to the bw1 aguryJ <br /> TANKED# A02 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK 0 Yes a3e <br /> `I �TAOl15817 Owens Corni I-Yn',mmpltlem paa o eac6mmpmlmml. <br /> DATE INSTALLED(YEAR/M0) 435 TANK CAPACITY IN GALLONS ash NUMBER OF COMPART EN1S 4Tt <br /> 6101 q, NA <br /> AVON$ t`orf <br /> ADDITIONAL DESCRIPTION(rrF i me hmy) 1Th <br /> IL TANK CONTENTS <br /> TANK U§-F- PETROLEUM TYPE 419 <br /> 1. MOTOR VEHICLE FUEL ❑la. REGULAR UNLEADED ❑2. LEADED ❑5. LET FUEL <br /> (Nmneaweyrlae Pgmkm.Type) ❑Ib. PREMIUM UNLEADED 03. DIESEL 06. AVIATION FUEL <br /> ❑2 NON FUEL PETROLEUM ❑Ic. MIDGRADE UNLEADED ❑4. GASOHOL ❑99 OTHER <br /> ❑3.CHEMICAL PRODUCT COMMON NAME (r INeallo.0 mauriah m.<mwy wp<) °617CAS <br /> zrmam Male4ax <br /> ❑4. HAZARDOUS WASTE68 }76- 3Lf-6(le<IaN�e oo Dusk Fv& «// <br /> ❑95.UNKNOWN <br /> III. TANK CONSTRUCTION <br /> TYPE OF TANK I. SINCdE WALL 3. SINGLE WALL WITH Ms. SINGLE WALL V i III INTERNAL BLADDER SYSTEM M <br /> (Rwaoe em�omy) EXTERIOR MEMBRANE LINER 095.UNKNOWN <br /> Jl i DOUBLE WALL ❑4. SIGNLE WALL IN VAULT ❑99-OTHER <br /> TANK MATE11011amt111. &1151EL 3. FIBERGLASS/PLASTIC 5.CONCRETE 95.UNKNOWN 44s <br /> (CMA ns Day) ❑2. STAINLESS STEEL ❑4. STEEL CLAD WIFIBERGLASS ❑R FRP COMPTBLE W/100%METHANOL ❑99.OTHER <br /> REINFORCED PLASTIC(FRP) <br /> TANKMATEO -.ecm ,. 1. BARE STEEL I FIBERGLASS/PLASTIC 5. CONCRETE 0 95.UNKNOWN 445 <br /> (caatwe qm m1Y) ❑2. STAINLESS STEEL ❑4. STEEL CIA])W/FIBERGIASS ❑K FRP COMPTBLE W/100%METHANOL ❑99.OTtBR <br /> REINFORCED PLASTIC(FRP) ❑10-COATED STEEL <br /> ❑5. CONCRETE <br /> TANK INTERIOR LINING 1.RUBBER LINED ❑3.EPDXY LINING 5.GLASS LINING ❑95.UNKNOWN 4e6 DATE INSTALLED al <br /> OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ❑6 UNLINED ❑99 OTHER <br /> (LLeck onetm ae1Y) IF.mctl um otly) <br /> OTHER CORROSION ❑1 MANUFACTURED CATHODIC 13 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN w DATE INSTALLED 4ts <br /> PROTECTION IFAPPLICABLE PROTECTION ❑4IMPRESSED CURRENT ❑99 OTHER <br /> (Oaeh o.e�anh) ❑2 SACRIFICIAL ANODE (Fm local me my) <br /> SPILL AND OVERFILL YEAR INSTALLED 4m TYPE(meml meanly) 451 OVERFILLPROTECTION EQUEPWNTMEAR INSTALLED�rf 451 <br /> rylmctelltlmlapph) DOI SPILL CONTAINMENT ❑I ALARM IM 3 FILL TUBE SHUT OFF VALVE <br /> R 2 DROP TUBE ❑2 BALL FLOAT ❑4 EXEMPT <br /> LE 3 STRIKER PLATE <br /> IV.TANK LEAK DETECTION(A d ritdlmanbe mpvimriug IaaPam ran to a�mm�mamum m®1.s.my.) <br /> IF SINGLE WAIL TANK((:MA an um mNy) 153 IF DOUBLE WALL TANK OR TANK WITH BLADDER 114 <br /> (L3ect one Mm oely) <br /> ❑1VISUAL(EXPOSED PORTION ONLY) ❑5MANUAL TANK GAUGING(MTG) ❑1VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑2 AUTOMATIC TANK GAUGING(ATG) 0 VADOSE ZONE X 2 CONTINUOUS INTERSTITIAL MONITORING <br /> ❑3 CONTINUOUS ATG ❑T GROUNDWATER ❑3 MANUALMONITORING <br /> ❑4 STATISTICAL INVENTORY RECONCILIATION ❑R TANK TESTING <br /> (SIR) BIENNIAL,TANK TESTING El 99 OTHER <br /> IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 1ST <br /> gallons ❑Yes ❑ No <br /> UPCF(17/99 revised) 10 FoTmedy SWRCB Foem B <br />