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COMPLIANCE INFO_2005-2010
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2300 - Underground Storage Tank Program
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PR0232534
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COMPLIANCE INFO_2005-2010
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Last modified
11/19/2024 10:19:32 AM
Creation date
6/3/2020 9:57:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2005-2010
RECORD_ID
PR0232534
PE
2361
FACILITY_ID
FA0004547
FACILITY_NAME
CHEVRON STATION #201383
STREET_NUMBER
1960
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23402001
CURRENT_STATUS
01
SITE_LOCATION
1960 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
KBlackwell
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232534_1960 W ELEVENTH_2005-2010.tif
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EHD - Public
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Ask <br /> IED PROGRAM CONSOLIDATED FORIM <br /> UNDERGROUND STORAGE TANK <br /> OPERATING PERMIT APPLICATION-TANK INFORMATION (One form per UST) <br /> TYPE OF ACTION (Check one item only. For a UST closure or removal,complete only this section and Sections I,II,III,IV,and IX below) 430. <br /> ❑ 1.NEW PERMIT ® 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION <br /> ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL <br /> DATE UST PERMANENTLY CLOSED: 430x. I DATE EXISTING UST DISCOVERED: 430b. <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) _ - 1. <br /> BUSINESS NAME(Same as Facility Name or DBA-Doing Business As) 3 <br /> Chevron Station#201383 <br /> BUSINESS SITE ADDRESS 103. CITY 104. <br /> 1960 W 11th St. Tracy, CA 95376 <br /> II. TANK DESCRIPTION <br /> TANK ID# 432. TANK MANUFACTURER 433. TANK CONFIGURATION:THIS TANK IS 434. <br /> 1 XERXES ® 1.A STAND-ALONE TANK Complete one page for each <br /> ❑ 2.ONE IN A COMPARTMENTED UNIT compartment in the unit. <br /> DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS IN THE UNIT 437. <br /> 12/17/1992 12,000 0 <br /> III. TANK USE AND CONTENTS <br /> TANK USE ® la.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING ❑ lc.AVIATION FUELING 439. <br /> ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] <br /> ❑ 6:OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a. <br /> ...... ............................- . - ----._........................_._............................................................................................_.......__._............................._....- .........._.-_.._.........._....._._.._.................. <br /> CONTENTS PETROLEUM: ® la.REGULAR UNLEADED ❑ ]c.MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440. <br /> ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS <br /> 8_PETROLEUM <br /> (] BLEND FUEL ❑ 9.OTHER PETROLEUM S eci 440a. <br /> NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL <br /> ❑ 11.OTHER NON-PETROLEUM(Specify): 440b. <br /> IV. TANK CONSTRUCTION <br /> TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 443. <br /> .................................. ............................_.....-..._._..........-................................................__................................................................................................................................_-----.._............................................................. ................__._._.............................._ <br /> PRIMARY CONTAINMENT ❑ 1.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER <br /> aaa. <br /> ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 444x. <br /> ..........................._..-....................................._.........................._..__.-..__......._ _...._................._.. ........................................................................................._. .................................................. <br /> ❑ 6.EXTERIOR MEMBRANE LI . <br /> SECONDARY CONTAINMENT ❑ 1.STEEL ®3.FIBERGLASS LINER ❑ 7.JACKETED <br /> aas. <br /> ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 445x. <br /> ----.._.._.................----._....._.............................................................................................................................-......._.._ ........................ ._._............-.............................. .................................. <br /> OVERFILL PREVENTION ® 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT ® 3.FILL TUBE SHUT-OFF VALVE 452. <br /> ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT <br /> V. PRODUCT/WASTE PIPING CONSTRUCTION <br /> PIPING CONSTRUCTION ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 99.OTHER 460. <br /> -_ ........................_....__................................................................................................._................................... _. ....... <br /> SYSTEM TYPE ._ ® 1.PRESSURE [:12.GRAVITY ❑ 3.CONVENTIONAL SUCTION [1 4._SAFE SUCTION[23 CCR§2636(x)(3)3 458_ <br /> ...... <br /> PRIMARY CONTAINMENT ❑ I.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464. <br /> _..............._ ...-90:NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a. <br /> SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464b. <br /> ❑ 90.NONE [195.UNKNOWN ❑ 99.OTHER(Specify): 464c. <br /> _......_....._. ................................................................................................._......................... ------ .... .............................................. <br /> PIPING/TURBINE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d. <br /> VI. VENT,VAPOR RECOVERY(VR) AND RISER/FILL PIPE PIPING CONSTRUCTION <br /> VENT PRIMARY CONTAINMENT ® 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC [190.NONE ❑ 99.OTHER(Specify): 46641. <br /> ................................................................_....._.__.....................----..................._..............._................................................_._................................._............................----....._......................................_............_............_._.........._._._..........................._..-._....._....._........................................ <br /> .................... <br /> VENT SECONDARY CONTAINMENT ❑ 1.STEEL [14.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE [199.OTHER(Specify): 464fl. <br /> .... <br /> .................................................._.....-----..__........_..............-.._..__.._._........._....-�-----�---.................-----._......._._..---............................................................................................................................._..............._._......_............_.-.-...............-._...................................... ...................4644. <br /> VR PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): <br /> ............................................................................................----._.........---....._._.____.............._.._-----......._.- __......................................_......................................................................................................._.�..._..... <br /> VR SECONDARY CONTAINMENT [1 [1 [I4644. <br /> 1.STEEL 4.FIBERGLASS 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify): 46441. <br /> . . . <br /> ......................................................................................................................................__._..----._.................._........._......-------.................................................................................................................................._.-._._......................._...........---.._.................................. ...............;...... <br /> VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ® 90.NONE <br /> ........................................................................................................................................._._..........._..._..._..-_.._.................._........................._......................_.._...................................................-_............................_._...-----...............-_...._................................................................--.........................._..........._........_.......464'..._. <br /> RISER PRIMARY CONTAINMENT N 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 46aji;.,.,,, <br /> __.........._....................................................................................................-------......._-._............._........._._.._._...._...................._........-........................-......_...._..........................._.-.__........................._-._._......................................_..._.........................._..__.... <br /> RISER SECONDARY CONTAINMENT [11.STEEL ❑ 4.FIBERGLASS [110.RIGID PLASTIC M 90.NONE [199.OTHER(Specify): a64kl. <br /> ----..........................................................................................._........................_._....-_............................... ..................................----............._.................................................................................................................................................................--.............----......... <br /> ..................... <br /> FILL COMPONENTS INSTALLED ® 1.SPILL BUCK.._.ET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 4516-c. <br /> VII. UNDER DISPENSER CONTAINMENT (UDC) <br /> CONSTRUCTION TYPE ® L SINGLE WALL ® 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469s. <br /> .............................._..._......_........._......................................................................................................................................_._....................._..................................................................................................................................................................................................................................................................................--.............. <br /> CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS [110.RIGID PLASTIC ❑ 99.OTHER(Specify) 4b.69 <br /> VIII. CORROSION PROTECTION <br /> STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ❑ 6.ISOLATION 448. <br /> IX. APPLICANT SIGNATURE <br /> CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true, <br /> accurate,and in full compliance with legal requirements. <br /> APPLICANT SIGNATURE:1F9M(DWR979VEZ DATE 01/13/2009 470 <br /> APPLICANT NAME(print) Chevron Products CoJ FRED MARTINEZ 471. APPLICANT TITLE Chevron Retail HES Permit Desk 472 <br /> UPCF UST-11 Rev.(12/2007) <br />
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