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COMPLIANCE INFO_2005-2008
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2300 - Underground Storage Tank Program
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PR0231897
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COMPLIANCE INFO_2005-2008
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Last modified
2/15/2024 1:53:27 PM
Creation date
6/3/2020 9:54:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2005-2008
RECORD_ID
PR0231897
PE
2361
FACILITY_ID
FA0006443
FACILITY_NAME
Tracy Texaco
STREET_NUMBER
2375
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
23207003
CURRENT_STATUS
01
SITE_LOCATION
2375 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231897_2375 N TRACY_2005-2008.tif
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EHD - Public
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t ti , <br /> ATPIED PROGRAM CONSOLIDATED FORM _to <br /> TANKS N- / <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 1 '�/ � <br /> (Two pages per tank) <br /> Page_of <br /> TYPE OF ACTION ❑ 1.NEW PERMIT ❑ 4.AMENDED PERMIT 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY TANK CLOSURE 430. <br /> (Check one item only) ❑ 3.RENEWAL PERMIT ❑ 7.PERMANENTLY CLOSED ON SITE <br /> (Specify reason) (Specify reason) ❑ 8.TANK REMOVED <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3. FACILITY ID: 1 <br /> LOCATION WITHIN SITE(Optional) 431. <br /> 717' - w , �.A. C?I?_7 t; <br /> I.TANK DESCRIPTION <br /> (Ase4led plotplan.with the location of the UST system.includingbuiIdings and landmarks shall be submitted to the local'ageney.) <br /> TANK ID# ��L�►7�� 432 TANK MANUFACTURER 433. COMPARTMENTALIZED TANK ❑Yes No 434. <br /> If"Yes,"complete one page for each compartment. <br /> DATE INSTALLED 435. TANK CAPACITY IN GALLONS 436, NUMBER OF COMPARTMENTS <br /> (YEAR/MO) 437. <br /> p I L6, <br /> d`°l j , ��r� c t om►j I <br /> ADDITIONAL D SCRIPTION(For local use only) 438. <br /> II.TANK CONTENTS <br /> TANK USE 439. PETROLEUM TYPE 440. <br /> W 1. MOTOR VEHICLE FUEL (%aa. REGULAR UNLEADED ❑2. LEADED ❑S. JET FUEL <br /> (Ifchecked,complete Petroleum Type) ❑lb. PREMIUM UNLEADED ❑3. DIESEL [16. AVIATION GAS <br /> ❑ 2. NON-FUEL PETROLEUM ❑1 c. MIDGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER: <br /> ❑ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441. CAS#(from Hazardous Materials Inventory page) 442 <br /> ❑ 4. HAZARDOUS WASTE <br /> (Includes Used Oil) <br /> ❑ 95.UNKNOWN <br /> III.TANK CONSTRUCTION <br /> TYPE OF TANK ❑1. SINGLE WALL ❑3. SINGLE WALL WITH EXTERIOR ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443. <br /> (Check one item only) MEMBRANE LINER ❑95. UNKNOWN <br /> 2. DOUBLE WALL ❑4. SINGLE WALL IN A VAULT ❑99. OTHER <br /> TANK MATERIAL-primary tank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC [15. CONCRETE IZ95.UNKNOWN 444. <br /> (Check one item only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE ❑99.OTHER: <br /> REINFORCED PLASTIC FRP W/100%METHANOL <br /> TANK MATERIAL-secondary tank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑8. FRP COMPTIBLE W/100%METHANOL J9 95.UNKNOWN 445. <br /> (Check one item only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS [39. FRP NON-CORRODABLE JACKET ❑99.OTHER <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 446. DATE INSTALLED 447. <br /> OR COATING ❑2.ALKYD LINING ❑4.PHENOLIC LINING ❑6.UNLINED ❑99.OTHER <br /> (Check one item only) <br /> OTHER CORROSION ❑1.MANUFACTURED CATHODIC ❑3.FIBERGLASS REINFORCED PLASTIC ❑95.UNKNOWN 448. DATE INSTALLED 449. <br /> PROTECTION PROTECTION [14.IMPRESSED CURRENT ❑99.OTHER <br /> f A licable ❑2.SACRIFICIAL ANODE <br /> SPILL AND OVERFILL YEAR INSTALLED 450. TYPE 451. OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452. <br /> (Check all that apply) 'S 1.SPILL CONTAINMENT ❑1.ALARM ❑3.FILL TUBE SHUT OFF VALVE <br /> 2.DROP TUBE ❑2.BALL FLOAT ❑4.EXEMPT <br /> STRIKER PLATE <br /> IV.TANK LEAK DETECTION <br /> (A description of the monitoring program shall be submitted to the local agency.) <br /> IF SINGLE WALL TANK 453. IF DOUBLE WALL TANK OR TANK WITH BLADDER 454. <br /> (Check all that apply) (Check one item only) <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 %r-.,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 /> V.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? 451. <br /> gallons ❑Yes ❑ No <br /> UPCF hwfwrc-b(1/99)-1/4 http://www.unidoes.org Rev.02/16/00 <br />
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