BILLING - Laserfiche WebLink

Home Browse Search

FIED PROGRAM CONSOLIDATED FORM TANK: TA0515734 PR H: PRO523165 UNDERGROUND STORAGE TANKS - TANK PAGE 1 I��AC#: FA0015637 ( (two pages per tank) ,,,��',,ass111///��)��`/• TYPEOFACTION Page 2 o1`3 (Cnak only noon only) ❑ INEW SITE PERMIT ❑ 4AMENDED PERMIF ❑ 5 CHANGEOF INFORMATION ❑ 6 TEMPORARY SITECLOSURE ❑ 7 PERMANENTLY CLOSED ON SITE ` ❑3RENEWAL PERMIT (Spaify rcawa.forlamuse oNv) . (Spa fy,cwn [ locd N).: ❑STANK REMOVED 430 BUSINESS NAMES.on FACILITY NAME.DBA m 9Busmms As) FACILITY ID PRH I HOTEL STOCKTON INVESTORS 3 FA0015637 PRO523165 LOCATION WITHIN SITE(opumm) 133 E WEBER AVE,STOCKTON 431 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 IDH Owners Tank ID#: 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑yes ❑No 434 e#�j89J§$9494 1 UNKNOWN Yes",mmpla omp g fm lowmpuv mt. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 2,000 I ADDITIONAL DESCRIPTION(Fm lmm uuauy) 439 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE HO ❑ L MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑2.LEADED ❑5.BET FUEL pfnimkul mmpluclktrolmm Typc) ❑ 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 Hva Mutuals lmwwypo c) 441 CASH(ham Hnmdaus Materiels lnvcntmy page) 443 ❑ 4.HAZARDOUS WASTE (Ioduda Ux Oil) ® 95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ® L.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Cloak uc imn only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ❑ 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ W.OTHER TANK MATERIAL-primary tank ® 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑5.CONCRETE ❑ 95.UNKNOWN 444 (Chale a,a ikm,mly) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ S.FRP COMPTIBLE W/100%.METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ L.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Cloak tune imn only) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/I0011.METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LMING ❑ 1.RUBBER LINED OR COATING ❑3.EPDXY LINING E] 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 4l7 (Ole k one item only) ❑2 ALKYD LIVING ❑4 PHENOLIC LINING ® 6 UNLINED ❑ 99.OTHER (FmlaaluuaNy) OTHERPROTECTION C ION IF PP ❑PROTECTION MANUFACTURING CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC 95 UNKNOWN 449 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ❑ (Cd .im000b) F1 2 SACRIFICIAL ANODE El4 IMPRESSED CURRENT ElWOTHER (Fm IaW use only) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(1m4.anly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chcckallthatapply) ❑ I SPILL CONTAINMENT ❑ IALARM ❑ 3 FILL TUBE SHUT OFF VAD ❑ 2DROPTUBE ❑ 2BALL ❑ 4EXEMPT ❑ 3STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A dcsmptim ofllhe mmimdng pmg m shall In subnuual tothe bcel agvayJ IN SINGLE WALL TANK(Clud:ee Nat@ply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) (Chakmeitanony) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3CONTW000S ATG ❑ 7GROUNDWATER ❑2 CONTINUOUS MTERSTITIALMONRORING ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK TESTING (SIR)BIENNIALTANK TESTING ❑ 3MANUAL MONITORING 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 8/30/2004 12:00:OOAM 0.00 gallons ❑Yes ❑No UPCF(12/99 revised)