COMPLIANCE INFO_1996-2005 - Laserfiche WebLink

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9//r by 3 UNED PROGRAM CONSOLIDATED �M Ot! `' av/ - TANKS UNDERGROUND STORAGE TANKS -TANK (two pages per tank) �J Page of TYPE OF ACTION r 1. NEW SITE PERMIT r 4. AMENDED PERMIT r 5. CHANGE OF INFORMATION) PORARY SITE CLOSURE (Check one item only)r 2. OPERATOR CHANGE r 7. PERMANENTLY CLOSED ON SITE X3. RENEWAL PERMIT (Specify reason-for local use only) (Specify change-for local use only) r 8. TANr K REMOVED 430 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 FACILITY ID# 1 Ripon Shell I F LOCATION WITHIN SITE(Optional)431 341 E. Main Street, Ripon, CA 95366 1.TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID#5 7,4 DJim'V9)k -j Gr 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK F Yes X No 434 135816-Regular Xerxes If AYes=_,complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1996 15,000 0ne ADDITIONAL DESCRIPTION(For local use only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 X 1. MOTOR VEHICLE FUEL X la. REGULAR UNLEADED r 2. LEADED r 5. JET FUEL (If marked,complete Petroleum Type) r 1b. PREMIUM UNLEADED r 3. DIESEL r 6. AVIATION FUEL F 2. NON-FUEL PETROLEUM r 1c. MIDGRADE UNLEADED r 4. GASOHOL r 99. OTHER F 3. CHEMICAL PRODUCT F 4. HAZARDOUS WASTE(Includes COMMON NAME(from Hazardous Materials Inventory page)441 CAS#(from Hazardous Materials Inventory page) 442 Used Oil) F 95. UNKNOWN Ill.TANK CONSTRUCTION TYPE OF TANK r 1. SINGLE WALL r 3. SINGLE WALL WITH r 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) X 2. DOUBLE WALL EXTERIOR MEMBRANE LINER r 95. UNKNOWN F 4. SINGLE WALL IN A VAULT F99. OTHER TANK MATERIAL-primary tank r 1. BARE STEEL X 3. FIBERGLASS/PLASTIC r 5. CONCRETE F95. UNKNOWN 444 (Check one item only) r 2. STAINLESS STEEL r 4. STEEL CLAD W/FIBERGLASS r 8. FRP COMPATIBLE W1100%METHANOL r 99. OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL-secondary r 1. BARE STEEL X 3. FIBERGLASS I PLASTIC r 8. FRP COMPATIBLE W/100%METHANOL r95. UNKNOWN 445 tank r 2. STAINLESS STEEL r 4. STEEL CLAD W/FIBERGLASS r 9. FRP NON-CORRODIBLE JACKET r 99. OTHER (Check one item only) REINFORCED PLASTIC(FRP) F 10. COATED STEEL F 5. CONCRETE TANK INTERIOR LINING r 1. RUBBER LINED r 3. EPDXY LINING r 5. GLASS LINING IF 95. UNKNOWN446 DATE INSTALLED 447 OR COATING F 2. ALKYD LINING r 4. PHENOLIC LINING X 6. UNLINED r 99. OTHER (Check one item only) (For local use only) OTHER CORROSION r 1. MANUFACTURED X 3. FIBERGLASS REINFORCED PLASTIC F95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE CATHODIC r 4. IMPRESSED CURRENT r 99. OTHER (Check one item only) PROTECTION (For local use only) F 2. SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED TYPE(For local use only)451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 450 (Check all that apply) X 1. SPILL CONTAINMENT_1996_ X 1. ALARM 1998 X 3. FILL TUBE SHUT OFF VALVE 1996_ X2. DROPTUBE 1996 r 2. BALL FLOAT r 4. EXEMPT X 3. STRIKER PLATE 1996 IV. TANK LEAK DETECTION<:(A description of the monitoring program shall be submitted to the local agency_) IF SINGLE WALL TANK(Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER(Check one item only). 454 F 1, VISUAL(EXPOSED PORTION ONLY) r 5. MANUAL TANK GAUGING(MTG) r 1. VISUAL(SINGLE WALL IN VAULT ONLY) F 2. AUTOMATIC TANK GAUGING(ATG) r 6. VADOSE ZONE X2. CONTINUOUS INTERSTITIAL MONITORING F 3. CONTINUOUS ATG IF 7. GROUNDWATER r 3. MANUAL MONITORING F 4. STATISTICAL INVENTORY RECONCILIATION(SIR)+ r 8. TANK TESTING BIENNIAL TANK TESTING r 99. OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons r Yes r No UPCF(1/99 revised) Formerly SWRCB Form B 6