Laserfiche WebLink
D PROGRAM CONSOLIDATED FO <br /> TANKS <br /> UNDERGROUND STORAGE TANKS -TANK PAGE 1 <br /> P g of 2 b <br /> TYPEOFACDON ❑INEW SITEPERMIT ❑ 4 AMENDEDPFRMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE L ` <br /> (CLeaaee aem my) ❑ 7 PERMANENTLY CLOSED ON SITE I1�1 G✓ <br /> ❑ 3 RENEWAL PERMIT (Spdfye•f^e-fwlaolieemly) Spfy n -fm,mlmewly) ❑ 8 TANK REMOVED 43e ` <br /> BUSINESS NAME(s a,e o FACILITY NAMI DB.S-meg 6eior I Aal 3 FACULTY ID: <br /> san joa Uin Re iwL r'G� <br /> LOCATION WITHIN SITE(opro..0 45I <br /> L TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks sbel be submitted In the local agency.) <br /> TANK ID# tl2TANK MANUFACTURER 433 COMPARTMENTALIZED TANK Yes o 4u <br /> 7Ao11581 TAN; <br /> corninq Yu'.=m9,aem p g fm xt mmpvm mt. <br /> DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 <br /> 5'/1002- I 2"wo gallons NA <br /> ADDITIONAL DESCRIPTION EF.Il.my) AM <br /> IL TANKCONTENTS <br /> TANK USE A39 PETROLEUMTYPE 4R, <br /> R,1.MOTOR VEHICLE FUEL 10 Is. REGULAR UNLEADED El 2. LEADED ❑5. JET FUEL <br /> (Itm.rteacmq,ee l'efmlemn Type) 01b. PREMIUM UNLEADED (3 3. DIESEL ❑6. AVIATION FUEL <br /> ❑Z NON-FUEL PETROLEUM ❑1c. M[DGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER <br /> ❑3. CHEMICAL PRODUCT COMMON NAME(fmmwvw.o.Memwls mamas Pluo L1I CAS# "2 <br /> ❑4. HAZARDOUS WASTE �[p��//�� <br /> (Ml.ds Useaoiy Ireplfar Urluzic f/ 9asoLlne GHS W 111 -61-q <br /> ❑95.UNKNOWN VV <br /> UL TANK CONSTRUCTION <br /> TYPE OF TANK Ll 1. SINGLE WALL L1 3. SINGLE WALL WITH Lj 5. SINGLE WALL WITH ITTERNAL BLADDER SYSTEM 43 <br /> ((Leek one aem ods) EXTERIOR MEMBRANE LINER ❑95. UNKNOWN <br /> 2. DOUBLE WALL ❑4. SIGNLE WALL IN VAULT ❑99. OTHER <br /> TANK MATERIAL-primary trot LJ 1. BARESTEEL U43. FIBERGLASS/PLASTIC L1 5.CONCRETE El 95. UNKNOWN 444 <br /> (C6e=k me ken Osly) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPTIBLE W/100%METHANOL ❑99.OTHER <br /> REINFORCED PLASTIC(ARP) <br /> TANKMATERIAL-.c ,flak 0 L BARESTEEL PC 3. FMERGLASS/PLASTIC U S. CONCRETE Ll 95,UNKNOWN M5 <br /> (LMck me am OWY) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/HBERGLASS ❑K FRP COMFMLE W/l0 .METHANOL ❑99.OTHER <br /> RFPNFORCED PLASTIC(FRP) ❑10.COATED STEEL <br /> ❑5. CONCRETE <br /> TANK INTERIOR LINING L RUBBER LINED ❑3.EPDXY LINING yl 5.GLASS LINING 0 95.UNKNOWN 446 DATE INSTALLED M7 <br /> OR COATING 1:12 ALKYD LINING ❑4 PHENOLIC LINING ❑6 UNLINED ❑99 OTHER <br /> ((Lett ooe ft.o Y) (Fwloa,aeetly) <br /> OTHER CORROSION ❑I MANUFACTURED CATHODIC 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN DATE INSTALLED 09 <br /> PROTECTION IF APPLICABLE PROTECTION 14IMPRESSEDCURRENT ❑99 OTHER <br /> (t Nme.Iy) ❑2 SACRIFICIAL ANODE (Fa lm.l ee mly) <br /> SPILL AND OVERFILL YEAR INSTALLED AAI TYPE(bealo.emly) ASI OVERFILL PROTECTION EQUIPisMENT:YEARINSTALLED 1 153 <br /> (CMaa1l1w1,p1y) 1 SPILL CONTAINMENT 0 ALARM X 3 FILL TUBE SHUT OFF VALVE <br /> 2 DROP TUBE ❑2 BALL FLOAT ❑4 EXEMPT <br /> 3 STRIKER PLATE <br /> IV.TANK LEAK DETECTION(A de.aipfine oftbe momemeg p .ama to e.nmitfa mthe 1a1 al <br /> IF SINGLE WALL TANK(Oil a0 tkat.pply) A53 IF DOUBLE WALL TANK OR TANK WITH BLADDER 4K <br /> (Coca Ow aro oey) <br /> ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE PO 2 CONTINUOUS INTERSTITIAL MONITORING <br /> ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING <br /> ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING <br /> (SIR) BIENNIAL TANK TESTING ❑99 OTHER <br /> IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE W PLACE <br /> ESTIMATED DATE LAST USED(YR/MOMAY) 05 ESTIMATEDQUANTIYOF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 4fl <br /> gallons []Yes ❑ No <br /> UPCF(12/99 revised) 10 Formerly SWRCB Form B <br />