BILLING 1986 - 1999 - Laserfiche WebLink

Home Browse Search

U NIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS -TANK PAGE 1 (two pages per tank) II Page of TYPE OF ACTION ❑1.NEW SITE PERMIT ❑ 4. AMENDED PERMIT CHANGE OF INFORMATION) ❑ e TEMPORARY SITE CLOSURE (Check ane item only) s..��/ ❑ 7, PERMANENTLY CLOSED ON SLTE Lrtl 3.RENEWAL PERMIT (Sp,xfy mason-for Intal use only) (Speo'fy change•for local use only) ❑ g. TANK REMOVED 430 BUSINESS NAME(Same as FACILITY NAME or DBA-Domg Business Asp FACILITY ID 0 1 LOCATION WITHIN SITE(Opaonso 431 1� 2"l r C/ r JV VV -Wl� L TANK DESCRIPTION TANK IO 9 5 TANK MANUFACTURER COMPARTMENTALIZED TANK C3Yes /` 1 r+O -FCC FIf'Yai,complete one page for each u7mpar^.er.c DATE lH SIi LLED(YF-.1ARlMO) TANK CAPACITY IN�L � NUMBER 23F COMPARTMENTS - ADDITIONAL DESCRIPTION FFarlxal use only) IL TANK CONTENTS TANK USE 432 PETROLEUM TYPE 1 MOTOR VEHICLE FUEL "❑1a. REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL (Ir martr:i,Complete Pe(rpleum Type) ,❑Ito PREMIUM UNLEADED 1. DIESEL ❑ 8 AVIATION FUEL ❑ 2 NON-FUELPETROLEUM ❑1C MIOGRACEUNLEADEO ❑ 4 GASOHOL ❑99 OTHER ❑ 3. CHEMICAL PRODUCT - COMMON NAME(Nom Hazardous Matahals fnranrcry page) CAS>f(from Hazardous Materials fnvenfory page) ❑ 4. HAZARDOUS WASTE(fricfudes /� (' J Used 0 C-.t./fqpj wrle r> x 111.TANK CONSTRUCTION _ TYPE OF TANK ❑ 1/SINGLE WALE ❑ 3. SINGLE WALL WITH Q 5 SINGLE WALL WITH INTERNAL BIAOOER SYSTEM {Check one dem only) •CQ 2 pOUBLE WALL EXTERIOR MEMBRANE LINER ❑95 UNKNOWN ❑ 4 SINGLE% ALL IN A VAULT ❑99 OTHER TANK MATERIAL-primary tank .❑ 1 BARE STEEL 3. FIBERGLASS f PLASTIC. ❑ 5 CONCRETE ❑95 UNKNOWN (Check one dem cnlyY ❑ 2 STAINLESS STEEL ❑4. STEEL CLAD WIFIBERGLASS ❑ 8. FRP COMPATIBLE W1100%METHANOL ❑99, OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL-secondarytank ,❑ 1 BARE STEEL 3 FIBERGLASS I PLASTIC ❑ 8. FRP COMPATIBLE W1100%METHANOL ❑95 UNKNOWN (Check one item only) ❑ 2. STAINLESS STEEL ❑ 4. STEEL CLAD WIFIBERGLASS ❑ 9. FRP NON-CORRCOIBLE JACKET ❑99. OTHER REINFORCED PLASTIC(FRP) I❑1C COATED STEEL ❑ 5. CONCRETE TANK INTERIOR LINING1. RUBBER LINED ❑ 3. EPDXY LINING 11 GLASS LINING El 95. UNKNOVWM433 DATE INSTALLED OR COATING El 2, ALKYO LINING El 4, PHENOLIC LINING . B. UNLINED ❑99, OTHER (Check ane item on!) (Far local use only! OTHER CORROSION ❑ 1. MANUFACTURED CATHODIC 3. FIBERGLASS REINFORCED PLASTIC ❑95. UNKNOWN A34 DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION ❑ 4. IMPRESSED CURRENT ❑99. OTHER (Check one item only) ❑ 2, SACRIFICIAL ANODE (Forlocal use cnry) SPILL ANO OVERFILL YEAR INSTALLED TYPE(Forlocal use only) OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED (Check ail that appy) rVZ SPILL CONTAFNMEN7 1. AL4RM 3,`FILL TUSE SHUT OFF VALVEDROP TUBE f M 2. BALL FLOAT J �❑ 4, EXEMPT LIQ 3. STRIKER PLATE N. TANK LEAK DETECTION IF SINGLE WALL TANK(Check all that apply): IF DOUBLE WALL TANK OR TANK 1"ItTH BLADDER(Check one item oMy7- 1. VISUAL(EXPOSED PORTION ONLY) ❑ 5. MANUAL TANK GAUGING(MTC) VISUAL(SINGLE WALL IN VAULT ONLY) [32. AUTOMATIC TANK GAUGING(ATG) ❑ t3. VADOSE ZONE 2. CONTINUOUS INTERSTITIAL MONITORING ❑ 3. CONTINUOUS ATG ❑ 7. GROUNDWATER ❑ 3. MANUAL MONITORING ❑ 4. STATISTICAL INVENTORY RECONCILIATION(SIR)+ ❑ 8. TANK TESTING BIENNIAL TANK TESTING ❑99. OTHER V.TANK CLOSURE INFORMATION J PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YWMOIDAY) ESTIMATED QUANTITY OF SUBSTANCE REMAINING 435 TANK FILLED WITH INERT MATERIAL') galrons ❑Yes ❑NO J u ❑99 ' CUPAFORM(4/99) Formerly SWRCB Farm B Y gallons ❑Yes ❑No J CUPAFORM(4199) Formerly SWRCB Form B