COMPLIANCE INFO_FILE 11 - Laserfiche WebLink

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4fi ' UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS-TANK PAGE 1 $82-01LI WGMG03 145 (two ages per tank) !'aae 1 of 1 (Chc.k "IYPE.OF ACTION ❑1.NEW SITE PERMIT ❑4.AMENDED PERMIT ®5 CHANGE OF INFORMATION ❑6.TEMPORARY SITE CLOSURE 1 1 one item mIy) ❑7.PERMANENTLY CLOSED ON SITF Md - ❑3.RENEWAL,PERMIT (Specify realm-for local use mIy) (specify malar-fur l-1 use Doty) ❑8.TANK REMOVED 430 BUSINESS NAME(lameaaFACUT'NA.sSEwDBA-DoineBusines4As) I FACILTTYIDk Lawrence Livermore National Laboratory-Site 300 ' 0 0 0 - 2 1 9 4 5 LOCATION WITHIN SITE(optional) 4)I Building 882 . 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 4 432 TANK MANUFACTURER 4)) COMPARTMF,NTALIZED TANK Ycs ®No ui 882-D 1 U 1 29 Modern Welding Co. Ir-res". ompl«e me page ft, -h-p--, DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY 1N GALLONS 436NUMBEK OF COhIPAR"fb'IENfS 437 1988/01 1500 1 ADDITIONAL DESCRIPTION(F«local use only) 4)s IL TANK CONTENTS TANK USE 419 PETROLEUM TYPE 440 ® 1 MOTOR VEHICLE FUEL. [Ila.REGULAR UNLEADED ❑2.LEADED ❑ 5 JET FUEL_ FUEL_ complete Petroleum Type) ❑lb.PREMIUM UNLEADED ®3.DII•SL•1- ❑ 6.AVIA I ION FUEL ❑ 2.NON-FUFL PETROLEUM ❑Ic.MID(IRADE UNLEADED ❑4.GASOHOL ❑99.OTI ICR ❑ 1.CHEMICAL PRODUCT COMMON NAME(rium 1laeari-Materia)s Im entorr page) •141 CAS9 frtom Huardous Maurials Iri-tttory pays) 442 ❑ 4.HAZARDOUS WASTE Diesel Fuel#2 6833=4-30-5 (Includo Used Oil) ❑95.UNKNOWN Ill. TANK CONSTRUCTION TYPE-OF TANK 1.SINGLE WALL ❑3.SINGLE WALL WITH 13 S.SINGLE WALL.WH 11 INITRNAL.HLADDFR SYSTEM 4; (Chock MIe iICOI Mds) ®2.DOUBLE WALL EXTERIOR MEMBRANE LINER ❑95.UNKNOWN ❑4 SINGLE WALL IN VAULT ❑99.OTHER TANK MA"IERIAL-primuy unk 0 1.BARE STEEL 3.FIBERGLASS/PLASTIC 0 5.CONCRETE -UNKNOWN 444 (cllak one ium Moly) [12.STAINLESS STEEL ❑4.STEEL CLAD Wf FIBERGLAS ❑8.FRP COMPATIBLE W,,100%METHANOL ❑99 O'(II[A REINFORCED PLASTIC(FRP'r TANK MATERIAL-se<wdny unk 0 1. BAKE STEEL 3.FIBERGLASS:PLASTIC 11 R.FRP COM[PATIALE W.-100%METHANOL Cl 95.UNKNOWN 445 (Chak one item only) ❑2. STAINLESS STEEL ®4.STEEL CLAD Wi FIBERGLASS ❑9.FRP NON-CORRODIBLE JACKET ❑99.OTHER REINFORCED PLASTIC(FRP) ❑10 COATED STEFU. 115.CONCRETE TANK 111NITERIOR LINING 11 I.RUBBER LINED 3.EPDXY LINING LJ 5.GLASS LINING L1 95.UNKNOWN 4-1e DAIT-.INSTALLED 447 OR COATING ❑2.ALKYD LINING ❑4.PHENOLIC LINING ®6.UNLINED 1199 OTHER (Check one item My) (For IM;aI use mIy) O'nIER CORROSION :48 DATE INSTALLED 44a L MANUFACTUKED CATHODIC ❑3.FIBERGLASS REINFORCED PLASTIC [195.UNKNOWN PROTECTION IF APPLICABLE PROTECTION ❑4.IMPRESSED CURRENT 1199,OTHER (Check tine item on)y) ❑2.SACRIFICIAL ANODE (FM lucnl u.se only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use mIy) 451 OVERFILL PROTECTION EQUIPMENT YEAR INSTALLED 452 (Check ell that apply) ®1.SPILL CONTAINMENT 2003 ❑1.ALARM ❑4 EXEMPT ®2.DROP TUBE 1999 ❑2.BALL FLOAT ®3.STRIKER PLATE Ing ®3.FILL TUBE SHUT OFF VALVE 12 IV, 'DANK LEAK DETECTION A dean dm of she mmitonn am shall be submitted to the local a enc•.s IF SINGLE WALL TANK 45; IF DOUBLE WALL-TANK OR TANK WITH BLADDER 454 Whack all lhm apply) (Ch k me item only) ❑1.VISUAL(EXPOSED PORTION ONLY) ❑ 5.MANUAL TANK GARGLE,'(,(MTG) 137.VISUAL.(SINGLE WALL IN VAULT ONLY) ❑2.AUTOMATIC TANK GAUGING(ATG) ❑ 6.VADOSE ZONE N 2.CONTINUOUS 1NTv..Rs,nTIAL.MONITORING ❑3.CONTINUOUS ATG ❑ 1.GROUNDWATER ❑3.MANUAL MONITORING ❑4.STATISTICAL INVENTORY RECONCILIATION ❑ 8.TANK TESTING (SIR)BIENNIAL.TANK TESTING ❑99.OTHER IV. "TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR1MOr•DAY) 45$ LS'TIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH TNERT MATF,RIAL° '5-' NA NA Gallons ❑Yes ❑No ®NA UPCF OV99 revised) Formerh•SWRCH Foran B