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STI SP001 AST Record <br /> Form completed by(Name) Date <br /> (Title) <br /> OWNER INFORMATION FACILITY INFORMATION INSTALLER INFORMATION <br /> Name Name Name <br /> City of Ripon City of Ripon—Fueling Station <br /> Number and Street Number and Street Number and Street <br /> 259 North Wilma Avenue 240 Doak Boulevard <br /> City,State,Zip Code City,State,Zip Code Ripon,California,95366 <br /> Ripon,California 95366 Ripon,California 95366 <br /> Regulatory facility ID number(if applicable) <br /> OWNER'S TANK ID Tl OTHER ID INITIAL SERVICE DATE Unknown <br /> Manufacturer:Containment Solutions Contents:Diesel Construction Date:2006 Last Repair/Reconstruction Date:Unknown <br /> Dimensions:30'x 8' Capacity: 10,000 Last Change of Product Date:Unknown <br /> Design: ®UL 2085 ❑SWRl ❑API ❑Other ❑Unknown <br /> ®Horizontal ❑Vertical ®Rectangular <br /> Construction: ❑Bare Steel ❑Cathodically Protected(Check one:A.❑Galvanic or B.❑Impressed Current)Date Installed: <br /> ❑Coated Steel ®Concrete encased steel ❑Stainless steel ❑Other <br /> ❑Double-Bottom ®Double-Wall ❑ Lined inside; Date lining installed: <br /> Spill control:❑Earthen Dike❑Steel Dike❑Concrete CRDM:®yes ❑no <br /> ❑None ®Other Double walled with overfill protection:Liquid level gauge and tank fill If yes,type:®Release Prevention Barrier®Elevated tank ❑Double bottom tank <br /> chart <br /> ®Double wall tank❑CE-AST ❑other <br /> Tank elevated on supports ®yes ❑no <br /> Support material: ®steel ❑concrete❑other <br /> Release Prevention Barrier: ®yes ❑no If yes,Date Installed: AST Category:®Category 1 ❑Category 2 ❑Category 3 <br /> If yes,Type:❑concrete®synthetic liner❑clay liner❑steel❑other <br /> AST Record Page 1 of 2 <br />