COMPLIANCE INFO_FILE 12 - Laserfiche WebLink

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FIED PROGRAM CONSOLIDATED FO TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 x'05 875-D1U2 (two pages per tank) Page I of 2 TYPE OF ACTION ❑ 1.NEW PERMIT ❑ 4.AMENDED PERMIT ❑ S.CHANGE OF INFORMATION ❑ 6.TEMPORARY TANK CLOSURE 430. (Check one item only) ❑ 3.RENEWAL PERMIT ❑ 7.PERMANENTLY CLOSED ON SITE (Specify reason) (Specify reason) ® 8.TANK REMOVED BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3. 1 FACILITY ID: 1 Lawrence Livermore National Lab LLNL -Site 300 F 3 Li LOCATION WITHIN SITE(Optional) 431. North side of Building 875 I.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# 432• TANK MANUFACTURER 433• COMPARTMENTALIZED TANK ❑Yes ® No 434. 32 194532 875-D 1 U2 Modern Welding Co.,Inc. If"Yes,"complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435• TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS 437. 1992/07 3,000 1 ADDITIONAL DESCRIPTION(For local use only) 438. II.TANK CONTENTS TANK USE 439• PETROLEUM TYPE 440. ® 1. MOTOR VEHICLE FUEL ❑la. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL (If checked,complete Petroleum Type) ❑Ib. PREMIUM UNLEADED ®3. DIESEL ❑6. AVIATION GAS ❑ 2. NON-FUEL PETROLEUM ❑]c. MID-GRADE UNLEADED ❑4. GASOHOL ❑99.OTHER: ❑ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441. CAS#(from Hazardous Materials Inventory page) 442• ❑ 4. HAZARDOUS WASTE Diesel fuel 42 68334-30-5 (Includes Used Oil) ❑ 95.UNKNOWN III.TANKCONSTRUCTION TYPE OF TANK 0 1. SINGLE WALL 0 3. SINGLE WALL WITH EXTERIOR 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443• (Check one item only) MEMBRANE LINER ❑95. UNKNOWN ®2. DOUBLE WALL ❑4. SINGLE WALL IN A VAULT ❑99. OTHER TANK MATERIAL-primary tank N 1. BARE S_T_EE_L____U 3. FIBERGLASS/PLASTIC El 5. CONCRETE 95.UNKNOWN 444. (Check one item only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE ❑99.OTHER: REINFORCED PLASTIC RP W/100%METHANOL TANK MATERIAL-secondary tank 0 1. BARE STEEL 3. FIBERGLASS/PLASTIC El 8. FRP COMPTIBLE W/100%METHANOL U 95.UNKNOWN 445. (Check one item only) ❑2. STAINLESS STEEL❑4. STEEL CLAD W/FIBERGLASS ❑9. FRP NON-CORRODABLE JACKET ❑99.OTHER REINFORCED PLASTIC(FRP) ❑10. COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING 1.RUBBER LINED El 3.EPDXY LINING U 5.GLASS LINING 0 95.UNKNOWN 446. DATE INSTALLED 447. OR COATING ❑2.ALKYD LINING ❑4.PHENOLIC LINING ®6.UNLINED ❑99.OTHER Check one item only) OTHER CORROSION El 1.MANUFACTURED CATHODIC Q 3.FIBERGLASS REINFORCED PLASTIC U 95.UNKNOWN 448. DATE INSTALLED 449. PROTECTION PROTECTION ❑4.IMPRESSED CURRENT ❑99.OTHER If A licable ❑2.SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED 450. 1 TYPE 451. OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452. (Check all that apply) ®1.SPILL CONTAINMENT 1992 ®1.ALARM 1992 ®3.FILL TUBE SHUT OFF VALVE 1992 ®2.DROP TUBE 1992 ®2.BALL FLOAT 1992 ❑4.EXEMPT ®3.STRIKER PLATE 1992 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 454. (Check one item only) ❑1.VISUAL(EXPOSED PORTION ONLY) ❑5.MANUAL TANK GAUGING(MTG) ❑1.VISUAL(SINGLE WALL IN VAULT ONLY) ❑2.AUTOMATIC TANK GAUGING(ATG) ❑6.VADOSE ZONE ®2.CONTINUOUS INTERSTITIAL MONITORING ❑3.CONTINUOUS ATG ❑7.GROUNDWATER ❑3.MANUAL MONITORING ❑4. STATISTICAL INVENTORY RECONCILIATION ❑8.TANK TESTING (SIR)+BIENNIAL TANK TESTING ❑99.OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455. ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456. 1 TANK FILLED WITH INERT MATERIAL? 457. NA-removed,not closed in place I 1 NA-removed.not closed in place gallons °' ❑Yes ❑ No ® NA r rnr•c nimn c...........r..caaronn c..-..,n