BILLING 2003 - 2009 - Laserfiche WebLink

Home Browse Search

'INIFIED PROGRAM CONSOLIDATED FOi TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page of TYPE OF ACTION ®1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Check one been only) ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT (Specify reason-far local use only) (Specify reason-for local use only) ❑ 8 TANK REMOVED 430 BUSINESS NAME(Sameas FACILITY NAME or DBA-Doing Business As) 3 FACILITY ID: 1 Unocal/Subway dba JD Singh Service Stations, LOCATION WITHIN SITE(Optional) 431 26485 Thornton Road, Thornton, CA 1.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 []Yes ® No 434 Contairnent Solutions IPYes-,complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 6-03 20,000 ADDITIONAL DESCRIPTION(For kcal use only) 4W It.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ao ®1. MOTOR VEHICLE FUEL ®Ia. REGULAR UNLEADED [12. LEADED [15. JET FUEL (If marked complete Petroleum Type) ❑1b. PREMIUM UNLEADED [13. DIESEL [16. AVIATION FUEL [12. NON-FUEL PETROLEUM ❑1c. MIDGRADE UNLEADED [14. GASOHOL ❑99.OTHER ❑3. CHEMICAL PRODUCT COMMON NAME (from Himme aus Materials Inventory page) 441 CAS#(from HaaaMous Materials Inventory page) 442 [14. HAZARDOUS WASTE (Incudes Used Oil) [195.UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK ❑ 1. SINGLE WALL ❑3.SINGLE WALL WITH [15. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one dem only) EXTERIOR MEMBRANE LINER ❑95. UNKNOWN 02. DOUBLE WALL []4, SIGNLE WALL IN VAULT ❑99. OTHER TANK MATERIAL-primary tank 1. BARE STEEL 03. FIBERGLASS/PLASTIC ❑5. CONCRETE [195. UNKNOWN 444 (Check one dem only) [12. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/ ❑99.OTHER REINFORCED PLASTIC(FRP) 100%METHANOL TANK MATERIAL-saconaary rank ❑1. BARE STEEL ®3. FIBERGLASS/PLASTIC ❑5. CONCRETE [195. UNKNOWN 445 (Check one item only) ❑2. STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE ❑99.OTHER REINFORCED PLASTIC(FRP) W/100%METHANOL [15. CONCRETE ❑10.COATED STEEL TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑3.EPDXY LINING ❑5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ❑6 UNLINED ❑99 OTHER (Chatic ane nem only) (For all use only) OTHER CORROSION ❑1 MANUFACTURED CATHODIC®3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER (CheUc one item only) ❑2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Cheek all ®1 SPILL CONTAINMENT .2003 that apply) 0 1 ALARM ❑3 FILL TUBE SHUT OFF VALVE ®2 DROP TUBE 2003 ®2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE 2003 IV.TANK LEAK DETECTION(A description of the monitoring program shall be submitted to the local agency) IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(Ml ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ®2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑STANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YRIMOIDAY) 455 ESTIMATED QUANTITY OF SUBSTANCE 456 TANK FILLED WITH IN MATERIAL? 457 REMAINING gallons ❑Yes ❑ No UPCF(1/99 revised) Formerly SWRCB Form B