BILLING 1997 - 2003 - Laserfiche WebLink

Home Browse Search

'IFIED PROGRAM CONSOLIDATED FO- R L ..r =TANKSUNDERGROUND STORAGE TANKS TANK PAGE 1 Page 5 of 6 TYPE OF ACTION ❑I NEW SITE PERMIT ❑ 4 AMENDED PERMIT ® 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Chmk one kern only) ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT (Spcdfyrcason-forlocaluseonly) (Specifyreaon-forlocalusconly) ❑ STANK REMOVED 410 BUSINESS NAME(Same as FACILITY NAME m DBA-Doing Businas As) 1 3 FACILITY ro: 0 0 ! 0 0 0 0 0 0 0 0 0 Chevron Station#91848 LOCATION WITHIN SITE(optiona0 431 1257 W Yosemite Ave.,Manteca,CA 95337 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 ID# 032 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK 0 Yes No 434 3 OW ENS CORNING If'Yee',complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 7/11/91 12000 0 ADDITIONAL DESCRIPTION(Fm heal use only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ®1. MOTOR VEHICLE FUEL ❑la. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL (Ifmarked complmePmokum Type) ®Ib. PREMIUM UNLEADED 03. DIESEL ❑6. AVIATION FUEL ❑2. NON-FUEL PETROLEUM ❑Ip_ MIDGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER ❑3. CHEMICAL PRODUCT COMMON NAME (0om Hazardous Matenals Inventory pace) 441 CAS#(6om Ha>Bdous Matenals Invemory page) 442 ❑4. HAZARDOUS WASTE (movestfaadoib PREMIUM UNLEADED 800-61-9 ❑95.UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK ❑1. SINGLE WALL [13. SINGLE WALL WITH ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chat one nem only) EXTERIOR MEMBRANE LINER ❑95. UNKNOWN ®2. DOUBLE WALL ❑4. SINGLE WALL IN VAULT ❑99. OTHER_ TANK MATERIAL-prinwq wit 1. BARE STEEL ®3. FIBERGLASS/PLASTIC 05. CONCRETE 95. UNKNOWN 4a (Chat one nem only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/100%METHANOL ❑99.OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL-arcondary tank [3 1. BARE STEEL ®3. FIBERGLASS/PLASTIC 05. CONCRETE ❑95. UNKNOWN 445 (Check on,nam only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE W/100°/METHANOL ❑99.OTHER REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING ❑1.RUBBER LINED 0 3.EPDXY LINING [15.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99 OTHER (Chink cave tam only) (For Inial uses only) OTHER CORROSION ❑]MANUFACTURED CATHODIC ®3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 448 PROTECTION IF APPLICABLE PROTECTION ❑4IMPRESSED CURRENT ❑99 OTHER (Check one hem only) ❑2 SACRIFICIAL ANODE (For heel use only) SPILL AND OVERFILL YEAR INSTALLED 45o TYPE(low nae only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) ®3 FILL TUBE SHUT OFF VALVE ®1 SPILL CONTAINMENT 1991 ®1 ALARM OPW 61-SO-4 N 2 DROP TUBE 1998 OPW 61-SO-4 ❑2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE Tank Mf IV.TANK LEAK DETECTION(A description ofthe monkming program awl Is sumnazed to the local Meray.) IF SINGLE WALL TANK(check an that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one Hem only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑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 ❑8 TANK TESTING (SIR) BIENNIAL TANK TESTING ❑99 OTHER IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ❑Yes ❑ No UPCF(1/99 revised) 177 Formerly SWRCB Form B