Laserfiche WebLink
C)- <br /> Adlk Alk <br /> IFIED PROGRAM CONSOLIDATED F vt <br /> E. <br /> UNDERGROUND STORAGE TANK <br /> OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per UST) <br /> Ti'PE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections I,Il,III,IV,and IX below) 430 <br /> ❑ I.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.0 OF INFORMATION <br /> ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST <br /> DATE UST PERMANENTLY CLOSED: 430a 1 DATE EXISTING UST DISCOV ; Sob <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) _ 1 <br /> 09 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> Pacific Bell Telephone Company dba AT&T Califomia UE046 <br /> BUSINESS SITE ADDRESS 103 CITY ENVIRONMENTAL ONMENTAL 104 <br /> 907 Lincoln Road Stockton L;f11 <br /> ti.TANK DESCRIPTION <br /> TANK ID# 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 <br /> UE0460002 MODERN WLD ®1.A STAND-ALONE TANK <br /> C-, ❑2.ONE IN A COMPARTMENTED UNIT. <br /> Complete one page for each companrocnt in the unit. <br /> DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 <br /> 1997 4000 1 <br /> M.TANK USE AND CONTENTS <br /> TANK USE ❑ la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ lc.AVIATION FUELING 439 <br /> ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includ.UsedOil) ® 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] <br /> ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a <br /> CONTENTS PETROLEUM: ❑ la.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 (Specify): 440a <br /> NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL <br /> 11.OTHER NON-PETROLEUMS if): 440b <br /> IV. TANK CONSTRUCTION <br /> TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 443 <br /> PRIMARY CONTAINMENT ® L STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 <br /> ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (specify): 444a <br /> SECONDARY CONTAINMENT ❑ 1.STEEL N 3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 <br /> ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 445a <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 I WASTE PIPING CONSTRUCTION <br /> PIPING CONSTRUCTION ❑1.SINGLE-WALLED ®2.DOUBL&WALLED ❑99.OTHER 460 <br /> SYSTEM TYPE ❑ 1.PRESSURE ❑ 2.GRAVITY ® 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(a)(3)] 458 <br /> PRIMARY CONTAINMENT ❑ 1.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 ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c <br /> PIPINGITURBINE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d <br /> VI.VENT,VAPOR RECOVERY(VR)AND RISER.t PILL PIPE PIPING CONSTRUCTION <br /> VENT PRIMARY CONTAINMENT Ej L STEEL 19 4.FIBERGLASS 0 10.RIGID PLASTIC 90.NONE 0 99.OTHER(Specify) 464e <br /> 464el <br /> VENT SECONDARY CONTAINMENT 1.STEEL Ij 4.FIBERGLASS 10.RIGID PLASTIC 1@ 90.NONE 0 99.OTHER(Specify) 464f <br /> 4641 <br /> VR PRIMARY CONTAINMENT 0 L STEEL 0 4.FIBERGLASS 0 10.RIGID PLASTIC 0 90.NONE 99.OTHER(Specify) 4646 <br /> 464SI <br /> VR SECONDARY CONTAINMENT 0 L STEEL 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE 99.OTHER(Specify) 464h <br /> 464h <br /> VENT PIPING TRANSITION SUMP TYPE 0 1.SINGLE WALL 2.DOUBLE WALL 0 90.NONE 4641 <br /> RISER PRIMARY CONTAINMENT 0 L STEEL 4.FIBERGLASS 10.RIGID PLASTIC U 90.NONE 99.OTHER(Specify) 4641 <br /> 464'I <br /> RISER SECONDARY CONTAINMENT ❑ L STEEL 0 4.FIBERGLASS El 10.RIGID PLASTIC 90.NONE 0 99.OTHER(Specify) 464k <br /> 464k <br /> FILL COMPONENTS INSTALLED IN 1.SPILL BUCKET C9 3.STRIKER PLATEIBOTTOM PROTECTOR C1 4.CONTAINMENT SUMP 45la-c <br /> VII.UNDER DISPENSER CONTAINMENT(UDC} <br /> CONSTRUCTION TYPE ❑ I.SINGLE WALL ❑ 2.DOUBLE WALL ® 3.NO DISPENSERS ❑ 90.NONE 469a <br /> CONSTRUCTION MATERIAL ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(S if) 469b-c <br /> VIII. CORROSION PROTECTION <br /> STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ® 6.ISOLATION 448. <br /> DL 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,accurate, <br /> and in full compliance with legal requirements. <br /> APPLICANT SIGNATURE DATE 470. <br /> 6/9/2009 <br /> APPLICANT NAME(print) 471. APPLICANT TITLE 472 <br /> Steven J Hall Manage , EMS <br /> IT1PrF ITCT_R-1/1 <br />