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"PIPED PROGRAM CONSOLIDATED F \`IN i A) <br /> TANKS <br /> UNDERGROUND STORAGE TANKS -TANK PAGE i <br /> (two pages per tank) <br /> Page_of_ <br /> TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT 05 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE <br /> (Check one item only) ❑ 7 PERMANENTLY CLOSED ON SITE <br /> ❑ 3 RENEWAL PERMIT (Specify reason-for local use only) (Specify reason-for local use only) ❑ 8 TANK REMOVED 430 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) FACILITY ID: rm3 '�h3 <br /> Verizon California Incorporated-Manteca CO <br /> LOCATION WITHIN SITE(Optional) 431 <br /> 430 W.Center Street <br /> 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.) <br /> TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ONO 434 <br /> Joor If"Yes",complete one page for each compartment. <br /> DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 <br /> 6/11/99 6,000 1 <br /> ADDITIONAL DESCRIPTION(For local use only) 438 <br /> II.TANK CONTENTS <br /> TANK USE 439 PETROLEUM TYPE 440 <br /> ®1. MOTOR VEHICLE FUEL ❑I a. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL <br /> (If marked complete Petroleum Type) ❑lb. PREMIUM UNLEADED ®3. DIESEL [16. AVIATION FUEL <br /> [12. NON-FUEL PETROLEUM ❑lc. MIDGRADE UNLEADED ❑4. GASOHOL [199.OTHER <br /> ❑3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) 442 <br /> ❑4. HAZARDOUS WASTE Diesel Fuel#2 068334-30-5 <br /> (Includes Used Oil) <br /> ❑95.UNKNOWN <br /> III. TANK CONSTRUCTION <br /> TYPE OF TANK ❑1. SINGLE WALL ❑3. SINGLE WALL WITH [15. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 <br /> (Check one item only) EXTERIOR MEMBRANE LINER [195. UNKNOWN <br /> 02. DOUBLE WALL [14. SIGNLE WALL IN VAULT ❑99. OTHER <br /> TANK MATERIAL-primary tank ®I. BARE STEEL [13. FIBERGLASS/PLASTIC ❑5. CONCRETE ❑95. UNKNOWN 444 <br /> (Check one item only) [12. STAINLESS STEEL ❑ 4. STEEL CLAD W/FIBERGLASS [18. FRP COMPTIBLE W/100%METHANOL [199.OTHER <br /> REINFORCED PLASTIC(FRP) <br /> TANK MATERIAL-secondary tank [11. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE ❑95. UNKNOWN 445 <br /> (Check one item only) ❑2. STAINLESS STEEL 04. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPTIBLE W/100%METHANOL ❑99.OTHER <br /> REINFORCED PLASTIC(FRP) ❑10.COATED STEEL <br /> ❑5. CONCRETE <br /> TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING ❑5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 <br /> OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING 06 UNLINED ❑99 OTHER <br /> (Check one item only) (For local use only) <br /> OTHER CORROSION 01 MANUFACTURED CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED 449 <br /> PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER <br /> (Check one item only) ❑2 SACRIFICIAL ANODE (For local use only) <br /> SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 <br /> (Check all that apply) N I SPILL CONTAINMENT 1999 ®1 ALARM 1999 ❑3 FILL TUBE SHUT OFF VALVE <br /> 02 DROP TUBE 1999 ❑2 BALL FLOAT ❑4 EXEMPT <br /> 03 STRIKER PLATE 1999 <br /> IV.TANK LEAK DETECTION(A description of the monitoring program shall be submitted to the local agency.) <br /> IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 <br /> (Check one item only) <br /> ❑I VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(ATG) ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE 02 CONTINUOUS INTERSTITIAL MONITORING <br /> ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING <br /> ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING <br /> (SIR) BIENNIAL TANK TESTING ❑99 OTHER <br /> IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 <br /> gallons ❑Yes ❑ No <br /> UPCF(12/99 revised) is 10 Formerly SWRCB Form B <br />