BILLING 2010 - 2013 - Laserfiche WebLink

Home Browse Search

Alk UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(one form per UST) a3o TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this sec i ion 5.CHANGE OF INFORMATION and sections 1,11,111,IV,and IX below) ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT 8,UST REMOVAL F16.TEMPORARY UST CLOSURE C] 7.UST PERMANENT CLOSURE ON SITE ❑ 430b 43oa DATE EXISTING UST DISCOVERED: DATE UST PERMANENTLY CLOSED: I. FACILITY INFORMATION l FACILITY ID#(Agency Use Only) - 3 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) ARCO 02076 103 CITY 104 BUSINESS SITE ADDRESS LODI 800 E KETTLEMAN LN II.TANK DESCRIPTION 434 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS TANK ID# 4 ®1.A STAND-ALONE TANK TA 3 tt. /` Xerxes () [:12.ONE IN A COMPARTMENTED UNIT. 437 DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 1992/1 10,000 III.TANK USE AND CONTENTS 439 TANK USE ® la.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING ❑ Ic.AVIATION FUELING ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] 439a ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ❑ lc.MIDGRADE UNLEADED ® lb.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS aaoa ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): NON-PETROLEUM:[17.USED OIL ❑ 10.ETHANOL 44o1b ❑ 1 L OTHER NON-PETROLEUM(Specify): IV. TANK CONSTRUCTION 443 TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 444 PRIMARY CONTAINMENT ❑ 1.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444a ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 445 SECONDARY CONTAINMENT ❑ 1.STEEL ®3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445a ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 452 OVERFILL PREVENTION ® 1.AUDIBLE&VISUAL ALARMS ® 2.BALL FLOAT ❑ 3.FILL TUBE SHUT-OFF VALVE ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION 460 PIPING CONSTRUCTION ❑ 1.SINGLE-WALLED ®2.DOUBLE-WALLED ❑99.OTHER 58 SYSTEM TYPE ® 1.PRESSURE [12.GRAVITY ❑ 3.CO [-14 CONVENTIONAL SUCTION 4.SAFE SUCTION[23 CCR§2636(a)(3)] 458 PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464a ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 4646 SECONDARY CONTAINMENT 131.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464c ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): a6ad PIPING/TURBINE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL El 90.NONE VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC El 90.90.NONE ❑ 99.OTHER(Specify) a464 464f VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) a64f1 VR PRIMARY CONTAINMENT ❑ I.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC El 90. 90.NONE ❑ 99.OTHER(Specify) 464 l 464h VR SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC N 90.NONE ❑ 99.OTHER(Specify) 464h1 464i. VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ® 90.NONE 464j RISER PRIMARY CONTAINMENT ® L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464'1 RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE El99.OTHER(Specify) 464k464k1 FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 451 a-c VII.UNDER DISPENSER CONTAINMENT(UDC) a69a CONSTRUCTION TYPE ® 1.SINGLE WALL E] 2.DOUBLE WALL [13.NO DISPENSERS ❑ 90.NONE CONSTRUCTION MATERIAL LSTEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 469b-c VIII. CORROSION PROTECTION 448 STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT E] 6.ISOLATION IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in full compliance with legal requirements. 470. APPLICANT SIGNAT DATE r I-J 10 APPLICANT NAME(print) N N I F R MARINAS 471. APPLICANT TITLE Environmental Compliance Special��472. UPCF UST-A Rev.(12/2007)