COMPLIANCE INFO_2012-2018 - Laserfiche WebLink

Home Browse Search

tic r 3c '2 qVVI UNIFIED PROGRAM CONSOLIDATED FORM ki, A y UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per UST) TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,IL 111,IV,and IX below) 430 ® 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION El 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 4302 DATE EXISTING UST DISCOVERED: 435 [. FACILITY 11VFOItMATION . FACILITY ID N(Agency Use onr�) F A 6. 6.'. - .,.0 O 0 6- t; BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Tesoro West Coast Company, LLC#68150 BUSINESS SITE ADDRESS 103 CITY 104 13975 e.Hwy 88 Lockeford.Ca.95237 IL TANK DESCRIPTION TANK IDN 00 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 Xcrses ❑ 1.A STAND-ALONE TANK N 2.ONE 1N A COMPARTMENTED UNIT. Com kte one page for each com aitmem in the unit. DATE UST SYSTEM I ALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 2012 S 20000 Two `I11.TANK USE AND CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ Ib MARINA FUELING ❑ Ic-AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4-HAZARDOUS WASTE(Imladcs Used Oil) ❑ 5 EMERGENCY GENERATOR FUEL[HSC g2S281.5(c)] ❑ 6.OTIIER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(S cify): 4392 CONTENTS PETROLEUM: ® la.REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEADED ❑ lb.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6-AVIATION GAS ❑ 8-PETROLEUM BLEND FUEL ❑ %OTHER PETROLEUM fspcciffiy 4402 NON-PETROLEUM ❑ 7 USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEU (Specify) 4406 IV.`TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ❑ 1.STEEL ® 3.FIBERGLASS ❑ 6 INTERNAL BLADDER 444 ❑ 7.STEEL 4 INTERNAL LINING [195.UNKNOWN ❑ 99.OTHER IS ): 444' SECONDARY CONTAINMENT [11.STEEL N 3.FIBERGLASS ❑ 6,EXTERIOR MEMBRANE LINER ❑ 7 JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ❑99 OTHER(S l: 445 OVERFILL PREVENTION I.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT N 3.FILL TUBE SHUT-OFF VALVE 4532 ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT I WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑1.SINGLE-WALLED N 2 DOUBLE-WALLED [199.OTHER 460 SYSTEM TYPE 0 1 PRESSURE ❑ 2.GRAVITY ❑ 3 CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR§206(ax3) 458 PRIMARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑ 90.NONE ❑ 95 UNKNOWN ❑ 99.OT'ItER(S y) 4642 SECONDARY CONTAINMENT ❑ 1 STEEL ® 4•FIBERGLASS ❑ S.FLEXIBLE ❑ 10.RIGID PLASTIC 464b ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99-OTHER(Specify): 464c PIPINGi TURBINE CONTAINMENT SUMP TYPE ❑ L SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE 4644 VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® 4 FIBERGLASS U 10 RIGID PLASTIC 0 90.NONE 0 99 OTHER(Specify) 464e 464e 1 VENT SECONDARY CONTAINMENT ❑ 1 STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464r 464n VR PRIMARY CONTAINMENT 0 1 STEEL 0 4 FIBERGLASS ❑ 10 RIGID PLASTIC D 90.NONE ❑ 99.OTHER(Specify) 4648 461 I VR SECONDARY CONTAINMENT 0 1 STEEL 0 4 FIBERGLASS 0 In RIGID PLASTIC 0 90.NONE El 99 OT'HI R(Specify) 464h 464h VENT PIPING TRANSITION SUMP TYPE 0 1,SINGLE WALL ® 2 DOUBLE WALL C3 90.NONE 4641. RISER PRIMARY CONTAINMENT N I STEEL CJ 4-FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4641 464'I RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS 0 10 RIGID PLASTIC M 90,NONE 99,OTHER(Specify) 464k 464k FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATEBOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 451 rc V11.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ❑ I.SINGLE WALL ® 2 DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 4641 CONSTRUCTION MATERIAL ❑ L STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTFLER(Specify) 4696~ VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENI ❑ &ISOLATION $ IX. APPLICANT SIGNATURE 4ym� CERTIFICATION: I certify that this LIST system is compatible with the hazardous substance stored and that the information provided herein is tru"ccurfte, and in full compliance with legal requirements. APPLICANT SIGNATUR6, `J DATE 2-23-12 APPLICANT NAh1E(print) andy Edwards �1 1 A71 APPLICAN r TITLE:Environmental Compliance Administrator 372 f PCF GST-B-112 Rev.(IZ