BILLING_1997-2003 - Laserfiche WebLink

Home Browse Search

UNIRD PROGRAM CONSOLIDATED FORMW TANKS UNDERGROUND STORAGE TANKS - TANK P GE i 1,,2- (two pages per tank) 51 ❑ 1 NEW SITE PERMIT El 5 of la TYPE OF ACTION ❑4 AMENDED PER MTT 5 GE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Check only item only) ❑ 7 PERMANENTLY CLOSED ON SITE ❑3 RENEWAL PERMIT ❑ 8TANK REMOVED 430 BUSINESS NAME(Same as FACILITY NAME m DBA-Doing Business M) FACILITY ID: I ARCO FACILITY#6335* ' FA0007571 LOCATION WITHIN SITE mptionol) 431 4'3-5 S ,H R PHONE 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.) TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK El Yes El No 434 5 XERXES If"Yos',comWe one pagefor each compartment. DATE INSTALLED(YEAR/MO) 431 TANK CAPACITY IN GALLONS a36 NUMBER OF COMPARTMENTS 437 3/16/1998 12,000 ADDITIONAL DESCRIPTION(Fm lord use only) 439 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 44o ® L MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑2.LEADED ❑ 5.!ET FUEL (Ifinerked complete Penn].Type) Ib.PREMIUM UNLEADED ❑ ❑3.DIESEL ❑ 6.AVIATION FUEL ❑2.NON-FUEL PETROLEUM ® Ic.MIDGRADE UNLEADED ❑4.GASOHOL ❑ 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(from HamNous Materials Invent CAS# from Heaerdous Mazerids(mento ❑4.HAZARDOUS WASTE orY page) HI ( rY Page) 44z pncmde Used Oil) ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one dem only) EXTERIOR MEMBRANE LINER El 95.UNKNOWN ®2.DOUBLE WALL ❑ 4.SINGLE WALL M VAULT ❑99.OTHER TANK MATERIAL-primary,tank ❑ 1.BARE STEEL ®FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (Check one item only) ❑2.STAINLESS STEEL ❑ STEEL CLAD W/FBERGLASS ❑ 8.FRP COMPTBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL [ 3.FIBERGLASS/PLASTIC El5.CONCRETE El 95.UNKNOWN 445 (Check one item only) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑ S.FRP COMPTBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ I RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑ 95.UNKNOWN 446 DATE INSTALLED a47 OR COATING (Check one hem only) [:12 ALKYD LINING ❑4 PHENOLIC LINING ® 6 UNLINED ❑ 99.OTHER - (Por lural me only) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED a49 PROTECTION IF APPLICABLE PROTECTION (Check one item only) ❑2 SACRIFICIAL ANODE E:14 IMPRESSED CURRENT El99 OTHER (For IoW uu only) SPILL AND OVERFILL / YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT,YEAR INSTALLED 452 (Check all that apply) L`f t�CP1LL CONTAINMENT 1998 ❑ 1 ALARM MI5 FILL TUBE SHUT OFF VALVE p DROP TUBE ❑ 2 BALL FLOAT ❑4 EXEMPT OPW LPI 9D ❑ 3 STRIKER PLATE IV.TANK LEAK DETECTION(A deemipion ofthe monitoring urogram shill x subeamed to the local ager y.) IF SINGLE WALL TANK(Cheek all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Cheek one item only) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL'? 457 gallons ❑ Yes ❑ No UPCF(12/99 revised)