Laserfiche WebLink
UNIFIED PROGRAM CONSOLIDATED FORM B <br /> UNDERGROUND STORAGE TANK <br /> OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per US <br /> TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,11,111,IV,and IX below) dao <br /> 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION <br /> ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE Q 8.UST REMOVAL <br /> DATE UST PERMANENTLY CLOSED. 4301 DATE EXISTING UST DISCOVERED: 4306 <br /> L ItACILTI'X INFORMATION <br /> _ - <br /> FACILITY ID N(Agency G'ae Only) F I A -.-, 0 0 1-- 1010 0 <br /> _.7. <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> Tesoro West Coast Company, LLC#68150 <br /> BUSINESS SITE ADDRESS 103 1 CITY 104 <br /> 13975 e.Hwy 88 Lockeford,Ca.95237 <br /> H.TANK DESCRIPTION <br /> TANK ID N 01 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 <br /> Xerxes ❑1.A STAND-ALONE TANK <br /> ®2.ONE IN A COMPARTMENTED UNIT. <br /> Cowlete o a for each tom mens in the unit. <br /> DATE UST STEM INS ALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 433 <br /> 2012 12000 TUFO <br /> III.TANK USE AND CONTENTS <br /> TANK USE ® la.MOTOR VEHICLE FUELING ❑ Ib.MARINA LIBELING ❑ Ic.AVIATION FUELING 439 <br /> ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.14AZ,ARDOUS WASTE(Include Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL(FISC§25281 5(c)) <br /> ❑ <br /> 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 439a <br /> CONTENTS PETROLEUM: ❑ Ia.REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEADED ® Ib.PREMIUM UNLEADED 440 <br /> ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS <br /> ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (S cifv): 440a <br /> NON-PETROLEUM.❑ 7 USED OIL ❑ 10.ET14ANOL <br /> ❑ 11.OTHER NON-PETROLEUM(S d) 4406 <br /> IV. TANK CONSTRUCTION <br /> TYPEOFTANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95 UNKNOWN 413 <br /> PRIMARY CONTAINMENT ❑ 1.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 <br /> ❑ 7.STEEL*INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (S cif-,): 4441 <br /> SECONDARY CONTAINMENT ❑ 1 STEEL ®3 FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7 JACKETED 445 <br /> ❑ 90.NONE ❑ 95,UNKNOWN ❑99.OTHER(Specify) 445& <br /> OVERFILL PREVENTION 9 1-AUDIBLE&VISUAL ALARMS U 2,BALL FLOAT M 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 ❑L SINGLE-WALLFD ®2 DOUBLE-WALLED [199,OTHER 460 <br /> SYSTEM TYPE ® 1.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL.SUCTION ❑ 4.SAFE SUCTION 23 CCR 42636(x)(3) 459 <br /> PRIMARY CONTAINMENT ❑ 1.STEEL ® 4 FIBERGLASS ❑ S.FLEXIBLE ❑ 10.RIGID PLAS"FIC 464 <br /> ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify). 464. <br /> SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464b <br /> ❑ 90_NONE ❑ 95-UNKNOWN ❑ 99-OTHER(Specify): 464c <br /> PIPING`URBINE 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 9 J.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90 NONE ❑ 99 OTHER(Specify) 464e <br /> 464c1 <br /> VENT SECONDARY CONTAINMENT ❑ 1.STEEL ® 4 FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90 NONE ❑ 99.OTHER(Specify) 464f <br /> *4n <br /> VR PRIMARY CONTAINMENT ❑ I STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90 NONE ❑ 99.OTHER(Specify) 4(48 <br /> 464g) <br /> VR SECONDARY CONTAINMENT ❑ i STEEL 4.FIBERGLASS 10 RIGID PLASTIC 0 90 NONE ❑ 99.OTIIER(Specify) 464h <br /> 464h1 <br /> VENT PIPINGTRANSITION SUMP TYPE ❑ !.SINGLE WALL. 2 DOUBLE WALL 90,NONE 464, <br /> RISER PRIMARY CONTAINMENT I STEEL 4 FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464j <br /> 464'1 <br /> RISER SECONDARY CONTAINMENT ❑ 1 STEEL 4 FIBERGI \SS 10 RIGID PLASTIC ® 90 NONE ❑ 99.OTHER(Specify) 464k <br /> 464k1 <br /> FILL COMPONENTS INSTALLED ® I SPILL BUCKET ® 3.STRIKER PLATE BOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 451■c <br /> VI1.UNDER DISPENSER CONTAINMENT(UDC) <br /> CONSTRUCTION TYPE ❑ I.SINGLE WALL ® 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 4691 <br /> CONSTRUCTION MATERIAL ❑ 1"STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99"OTHER(Specify) 409b-c <br /> VII! 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 As:true�kccurate, <br /> and in full compliance with legal requirements. <br /> APPLICANT SIGNATU DATE 2-23-12 *� 470 <br /> APPLICANT NAME(print) Sandy(Edwards 471 APPLICANT"TITLE Environmental Compliancc Administrator 677 <br /> s <br /> UPCF UST-B-112 [tiv "007) <br /> L'_ <br />