COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

.� - UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATIO (One�rm per USI) FTIZ7� YPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,H,III,IV,and IX below) 430 I: 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION I: ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430a DATE EXISTING UST DISCOVERED: 430 F I vi ILII t iavTORIYIATION FACILITY ID#(Agency Use Only) 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO 02133 BUSINESS SITE ADDRESS 103 CITY 104 2908 BENJAMIN HOLT DR STOCKTON TANK ID# 3 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 Modem Welding ®l LA STAND-ALONE TANK E•., •i'• �-,' :.., 7 `.. - 2.OT. E IN a COW R a E•n the unit. Completefor mchDATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 837 1999/04 10,000 I I .:III ,TANKUSE'gNll,CONTENTS TANK USE ® Ia.MOTOR VEHICLE FUELING ❑ ]b.MARINA FUELING ❑ le.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) [3 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a CONTENTS PETROLEUM: ❑ Ia.REGULAR UNLEADED El lc.MIDGRADE UNLEADED ® lb.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440a NON-PETROLEUM:❑ 7.USED OIL [1 10.ETHANOL E] 11.OTHER NON-PETROLEU (Specify): 440b TANK GONSTRUf TION TYPE OF TANK ❑ 1.SINGLE WALL N 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER a4a ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444a SECONDARY CONTAINMENT ❑ I.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ®99.OTHER(Specify): Steel Clad w/Fiber lass Reinforced Plastic 445a 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/ ASCE PIPING CONSTRUCTIdN: , ' PIPING CONSTRUCTION ❑1.SINGLE-WALLED ®2.DOUBLE-WALLED 1199.OTHER 460 SYSTEMTYPE EI L PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION(23 CCR§2636(8)(3)] 458 PRIMARY CONTAINMENT ❑ 1,STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 El90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 4646 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c PIPING/TURBTNE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 8648 VAPOTtCOVI>rRX'(VR)AND'RISER/FII;Y,.PII'E PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT U L STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE El 99.OTHER(Specify) 46ae 464el VENT SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 46441 f VR PRIMARY CONTAINMENT ❑ I.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4648 464 1 VR SECONDARY CONTAINMENT ❑ 1.STEEL [I4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE El99.OTHER(Specify) 464h 4646! VENT PIPING TRANSITION SUMP TYPE ® 1.SINGLE WALL 2.DOUBLE WALL 0 90.NONE 464'. RISER PRIMARY CONTAINMENT ® 1.STEEL [14.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4645 464'1 RISER SECONDARY CONTAINMENT El1.STEEL [14.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 4641 46411 FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATEBOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 45la•c VIL UNDER DISPENSER CONTAINMENT;(iJI�C); CONSTRUCTION TYPE ® 1.SINGLE WALL Cl 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGIDPLASTIC ❑ 99.OTHER(Specify) 4690-c CORROSYON.PROTCTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT `•❑ 6.ISOLATION 448. _ r IX: APPLICANT SIGNATURE . CERTIFICATION:I certify that this USTe�ystenr s compatible with the hazardous substance stored and that the information provided herein is true,accurate, and In full com lianc fit al requirements. APPLICANT SIGNATURE DATE 470 APPLICANT NAME(print) BRA Z ASAGOITIA 471, APPLICANT TITLE Environmental Compliance Specialist 472. UPCF UST-A Rev.(12/2007)