Laserfiche WebLink
0 <br /> STATE ID NUMBER O0000000723003 <br /> CONTAINER CONSTRUCTION <br /> Ol RUBBER LINED ( ) 02 ALKYD LINING ( ) 03 EPDXY LINING ( ) 04 PHENOLIC LINING E ) 05 GLASS LINING <br /> (X) 07 UNLINED ( 1 08 UNKNOWN ( ) 09 OTHER. <br /> 01 POLYETHLENE WRAP ( } 02 VINYL WRAPPING t ) 03 CATHODIC PROTECTION ( ) 04 UNKNOWN <br /> ( 06 TkR DR ASST ( ) 09 OTHER-: <br /> VI PIPING <br /> -A. ABOVEGROUND PIPING: ( 1 01 DOUBLE-WALLED PIPE ( J 02 CONCRETE-LINED TRENCH ( ) 03 GRAVITY <br /> (CHECK APPROPRIATE BOX(ES) ( ) 04 PRESSURE ( ) 05 SUCTION ( ) 06 UNKNOWN ( ) 07 NONE <br /> B. UNDERGROUND PIPING- 4 1 01 DOUBLE-WALLED PIPE ( ) 02 CONCRETE-LINED TRENCH ( ) 03 GRAVITY <br /> (CHECK APPROPRIATE BOX(ES) (X) 04 PRESSURE ( ) 05 SUCTION ( ) 06 UNKNOWN ( ) 07 NONE <br /> VII LEAK DETECTION - <br /> ( 1 01 VISUAL ( 02 STOC) Ry ( ) 05 SENSOR INSTRUMENT <br /> ( ) 06 GROUND WATER MUNIIUHINU WELLS ( ) 07 PRESSURE TEST ( 1 09 NONE ( J 10 OTHER: <br /> VIII CHEMICAL COMPOSITION OF MATERIALS STORED IN UNDERGROUND CONTAINERS <br /> IF YCU CHECKED YES TO IV-F YOU ARE NOT RE^,UIRED TO COMPLETE THIS SECTION <br /> CURPENTLY PREVICUSLY DELETE GAS# (IF KNOWN) CHEMICAL (DO NOT USE COMMERCIAL NAME) <br /> STOPED STORED - <br /> t ) 01 f ) 02 ( ) 03 <br /> ( ) 01 ( ) 02 ( } 03 <br /> C ( 1 01 ( ) 02 ( ) 03 <br /> ( ) 01 ( 1 02 ( 1 03 <br /> ( 1 01 ( ) 02 ( ) 03 <br /> 01 ( 1 02 ( ] 03 <br /> ( ) 01 ( J 02 i J 03 <br /> ( J <br /> 01 [ ) 02 t ) 03 <br /> ( ) <br /> 01 f J 02 ( 3 03 <br /> ( ) 01 ( 1 02 ( 1 03 LiLL <br /> CHECK STATE BOARD CHEMICAL CODE LISTING FOR POSSIBLE SYNONYMS <br /> IS CONTAINER LOCATED ON AN AGRICULTURAL FAFI? ( ) 01 YES (X) 02 NO <br /> THIS FOR AS BEEN COMPLETED UNDER THE PENALTY OF PERJURY AND, TO THE BEST OF MY KNOWLEDGE) IS TRUE AND CORRECT. <br /> PERSON FI , (SIGNATU I PHONE W/ARE,A CODE f 7arG <br /> `Z.G !_ O <br /> FOR L AGENCY USE ONLY <br /> csT CITY CODE COUNTY CODE <br /> AOMINI TRATIN3 A'ENCY [ <br /> lJl{ N 1�ca C.(A►•(.. l <br /> CONTACT PEP PHONE W/AREA CODE <br /> yl '2.O -- g -2'7�6 <br /> DATE OF LAST SPECTION IN COMPLIANCE <br /> PERMIT APPROVAL DATE TRANSACTION DATE LOCAL PERMIT ID # <br /> OI YES ( ) 42 ND <br /> PAGE z <br /> HSC04-070185 (10/13/65) <br />