BILLING 1993 - 2004 - Laserfiche WebLink

Home Browse Search

U�IED PROGRAM CONSOLIDATED FORS TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page 32 of43 TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Chook only farm only) ® ® ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT ❑ 8 TANK REMOVED 430 BUSINESS NAME(Satsess FAC1L1'IYNAME«DBA-Ikai Busmas N) 3 FACILITY III I AMERICAN MOULDING&MILLWORK 1 NIL FA0003555 LOCATION WITHIN STT'E(OPslonap I 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. TIDN © ,<!�/ 43z TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes Fol No 34 D U wyas",00rapar.oeejagalbliomci '1 DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 37 0 ADDITIONAL DES=use Doty) CC-e II.TANK CONTENTS 1Q� TANK USE 439 PETROLEUM TYPE 4 ❑ 1.MOTOR VEHICLE FUEL El a.REGULAR UNLEADED ❑ 2.LEADED El5.JET FUEL \ (If'"vkeA cosrykre Petroleum Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ lc MIDGRADE UNLEADED [14.GASOHOL ® 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(tont Hazardous Manarials Inventory page) 441 CAS#(born Hazardous Materials Inventory page) qq2 El4.HAZARDOUS WASTE (Includes used an 7:195.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL [13.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chock one item only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN [:12.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-privary tank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE [195.UNKNOWN 444 ((Zhuck 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 ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chink one nem only) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1 RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑ 95.UNKNOWN 446 DATE INSTALLED �? OR COATING (Check one nem only) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ❑ 6 UNLINED El 99 OTHER (For local tine Doty) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ❑ 3 FBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 44g DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Check one dem only) El IMPRESSED CURRENT ❑ 99 OTHER El 2 SACRIFICIAL ANODE (For local ux Doty) SPILL AND OVERFILL YEAR INSTALLED 45) TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check A than apply) ❑ 1 SPILL CONTAINMENT ❑ 1 ALARM ❑ 3 FILL TUBE SHUT OFF VALVE ❑ 2DROP TUBE [12 BALL FLOAT ❑ 4EXEMPT ❑ 3 STRIKER PLATE IV.TANK LEAK DETECTION(A description ofthc monlwrmg program shall be sublmned to the k�wl ages y.) I SINGLE WALL TANK(Chzck as that real 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Check 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? 451 allots ❑ Yes ❑ No UPCF(12/99 revised)