COMPLIANCE INFO_FILE 12 - Laserfiche WebLink

Home Browse Search

UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS-TANK PAGE I 882-D I U I WGMG03 145 tank) =111 I Page 1-of-z-, TYPE OF ACTION 0 1.NEW SITE PERMIT 04.AMENDED PERMIT 0 5.CHANGE OF INFORMATION 0 6.TEMPORARY SITE CLOSURE (Check one item only) T 0 7.PERMANENTLY CLOSED ON SITE 0 3.RENEWAL PERMIT (specify reason-for local use only) (Specify reason-for local use only) 0 8.TANK REMOVED 430 BUSINESS NAME(Same as FACILITY NAME m DRA-Doing 13-ress As) I FACILITY ID 3 19 0 0 0 2 13 1 1 19 14 15 Lawrence Livermore National Laboratory-Site 300 LOCATION WITHIN SITE(optional) 431 Building 882 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# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ElYes ®No 434 882-DIUI (29) Modem Welding Co. If-Yes",complete one page for each comp.m"rit DATE INSTALLED(YEAR/Mo) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 417 1988/01 1500 ADDITIONAL DESCRIPTION(For local use only) 439 11. TANK CONTENTS TANK USE 439 PEIROLEUM'IYPE 440 1 MOTOR VEHICLE FUEL 0]a.REGULAR UNLEADED [12 LEADED 0 S JTT FUEL (If marked complete Petroleum Type) 'E3 Ib.PREMIUM UNLEADED 0 3.DIESEL 0 6.AVIATION FUEL 0 2.NON-FUEI,PETROLEUM [-I le.MIDGRADF UNLEADED [14,GASOHOL 0 99.OTHER [1 3 CHEMICAL PRODUCT COMMON NAME(from 11-does Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) "2 0 4.HAZARDOUS WASTE Diesel Fuel#2 68334-30-5 (includes Used Oil) ❑95,UNKNOWN I III. TANK CONSTR13CTION TYPE OF TANK 0 1.SINGLE WALL 0 3.SINGLE WALLI%Iv"ITH [1 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) N 2.DOUBLE WALL EXTERIOR MEMBRANE LINER 0 95.UNKNOWN [:14.SINGLE WALL IN VAULT C3 99.OTHER TANK MATERIAL primary tank 0 I.BARE STEEL 0 3.FIBERGLASS/PLASTIC El 5.CONCRETE El 95.UNKNOWN 444 (Check one item only) 0 2.STAINLESS STEEL 0 4.STEEL CLAD W/FIBERGLAS [3 8,FRP COMPATIBLE W/100%METHANOL, 0 99,OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL secondary tank 0 1. BARE STEEL 0 3.FIBERGLASS/PLASTIC 0&FRP COMPATIBLE W/100%METHANOL C3 95.UNKNOWN 445 (Check one item only) 0 2. STAINLESS STEEL 0 4.STEEL CLAD W/FIBERGLASS 0 9,FRP NON-CORRODIBLE JACKET ❑99,OTHER REINFORCED PLASTIC(FRP) 0 10 COATED STEEL 0 5.CONCRETE TANK INTERIOR LINING 0 1.RUBBER LINED 3.EPDXY LINING 0 5.GLASS LINING El 95.UNKNOWN 446 DATE INSTALLED 447 OR COATING 0 2.ALKYD LINING 0 4.PHENOLIC LINING 0 6-UNLINED 0 99.OTHER (Check one item only) (For local use only) OTHER CORROSION 0 1.MANUFACTURED CATHODIC 0 3.FIBERGLASS REINFORCED PLASTIC 0 95.UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION 0 4.IMPRESSED CURRENT El 99.OTHER (Chock one item only) 0 2.SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL.1.PROTECTION EQUIPMENT YEAR INSTALLED 452 (Check all thatapply) 0 1.SPILL CONTAINMENT 2003 0 1 ALARM El 4.EXEMPT 0 2.DROP TUBE 1999 0 2.BALL FLOAT 19 3 S I RIKI;R PLATE 1988 0 3.FILL TUBE SHUT OFF VALVE 1999 IV. TANK LEAK DETECTION A description of the monitoring rogram shall be submitted to the local aecncy) IF SINGLE WALL TANK 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check all that apply) (Check one item only) 0 1.VISUAL(EXPOSED PORTION ONLY) ❑ 5.MANUAL TANK GAUGING(MTG) 0 1.VISUAL(SINGLE WALL IN VAULT ONLY) 0 2.AUTOMATIC TANK GAUGING(ATG) 0 6 VADOSF ZONE 0 2 CONTINUOUS INTERSTITIAL MONITORING 0 3.CONTINUOUS ATG Cl 7.GROUNDWATER 0 3.MANUAL MONITORING 0 4.STATISTICAL INVENTORY RECONCILIATION El &TANK TESTING (SIR)BIENNIAL TANK TESTING ❑99.OTHER IV. TANK CLOSURE INFORMATION I PERNIANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YRIMO/DAy) 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456TANK FILLED WITH INERT MATERIAL? 457 Yes NA NA E3 No N NA UPCF(12/99 revised) Formerly SWRCB Form B