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Environmental Health - Public
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EHD Program Facility Records by Street Name
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9691
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2300 - Underground Storage Tank Program
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PR0502479
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BILLING
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Entry Properties
Last modified
2/7/2021 10:13:23 PM
Creation date
11/7/2018 8:15:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
RECORD_ID
PR0502479
PE
2381
FACILITY_ID
FA0005463
FACILITY_NAME
Lone Creek Vineyards, LLC
STREET_NUMBER
9691
STREET_NAME
MURPHY
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
20316004
CURRENT_STATUS
02
SITE_LOCATION
9691 MURPHY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MURPHY\9691\PR0502479\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
2/2/2018 7:38:19 PM
QuestysRecordID
3781046
QuestysRecordType
12
QuestysStateID
1
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EHD - Public
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STATE OF CALIFORNIP WATER RESOURCESCONTRO' 'BOARD <br /> FORM `B': LINDEWGROLIND STORAGE TANK PROGRAM <br /> TANK TANK PERMIT APPLICATION INFORMATION (a. <br /> COMPLETE A SEPARATE FORM WITH THE FOLLOWING INFORMATION FOR EACH TANK. Z <br /> 10 <br /> MARK ONLY ❑ 1 NEW PERMIT ❑ 3 RENEWAL PERMIT ❑ 5 CHANGE OF INFORMATION 7 Pf~NENTLY CLOSED NK <br /> ONE ITEM ❑ 2 INTERIM PERMIT ❑ 4 AMENDED PERMIT ❑ 6 TEMPORARY TANK CLOSURE TANKREMOVED D <br /> FACILITY/SITE NAME WHERE TANK IS INSTALLED: FARM TANK-YES❑ NO w <br /> I. TANK DESCRIPTION COMPLETE ALL ITEMS-IF UNKNOWN—SO SPECIFY ZD W <br /> W <br /> A. OWNERS TANK ID q B. MANUFACTURED BY: Yk <br /> 'A <br /> C.YEAR INSTALLED /(f I / D. TANK CAPACITY IN GALLONS: QQO <br /> II. TANK qONTENTS IF(A.1),IS MARKED,COMPLETE ITEM C.IF(AlIS NOT MARKED,COMPLETE ITEM D. 100, <br /> A. 1 MOTOR VEHICLE FUEL ❑ 2 PETROLEUMC. ❑ 1 UNLEADED [—]2 LEADED 3 DIESEL <br /> [-13 CHEMICAL PRODUCT F-1B.4 OIL /, PRODUCT ❑4 GASAHOL ❑ 5 JET FUEL ❑6 AVIATION GAS <br /> ❑ 5 HAZARDOUS ❑ 80 EMPTY ❑95 UNKNOWN ❑2 WASTE ❑7 METHANOL ❑ 99 OTHER(DESCRIBE IN ITEM D,BELOW) <br /> D. IF NOT MOTOR VEHICLE FUEL,ENTER NAME OF <br /> HAZARDOUS SUBSTANCE STORED&C.A.S.# C.A.S.#: - <br /> III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOX A B,C,&D <br /> A TYPE OF 1 UBLEWALLEO F-13 SINGLE WALLED WITH EXTERIOR UNER ❑ 95 UNKNOWN <br /> SYSTEM NGLE WAIlID ❑4 SECONDARY CONTAINMENT ❑ 99 OTHER <br /> 1 STEEL/IRON ❑ 2 STAINLESS STEEL ❑ 3 FIBERGLASS ❑ 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC <br /> B.TANK <br /> MATERIAL F] 5 CONCRETE E] 6 POLYVINYLCHLORIDE ❑7 ALUMINUM F78 100%METHANOL COMPATIBLE FRP <br /> 9 BRONZE ❑ t0 GALVANIZED STEEL ❑95 UNKNOWN ❑99 OTHER <br /> C. INTERIOR F-11 RUBBER LINED ❑2 ALKYOUNING ❑3 EPDXY UNING 4 P OUCUNING <br /> LOJ1NG ❑5 GLASS NTNG ❑6 UNLINED EEf95 UNKNOWN <br /> ❑ ISUNING MATERIAL COMPATIBLEWITH 100%METHANOL? ❑YES ❑ NO ❑99 OTHER <br /> D. PROTECTIION ❑ 5 CATHODIC PROTECTION ❑91TAR OR NONE HALT ❑ 95 UNKNOWN ❑99RFIBERGLASS REINFORCED PLASTIC <br /> OTHER <br /> IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND, U IF UNDERGROUND,BOTH IF APPLICABLE <br /> A SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 91 NONE A 5 UNKNOWN A U 99 OTHER <br /> B. CONSTRUCTION A U I SINGLE WALLED A U 2 DOUBLE WALLED A U 3 LINED TRENCH A U 91 NONE ?,As UNKNOWN A U 99 OTHER <br /> A U 1 STEEL/IRON A U 2 STAINLESSSTEEL A U 3 POLYVINYL CHLORIDE(PVC) A U 4 FIBERGLASS PIPE A U 91 NONE <br /> C.MATERIAL A U S ALUMINUM A e CONCRETE A U 7 STEELCLADW/FRP A U 8 100%METHANOL COMPATIBLE FRP <br /> A U 9 GALVANIZED STEEL A U 95 UNKNOWN A U 99 OTHER <br /> V. LEAK DETECTION SYSTEM CIRCLE P FOR PRIMARY,OR S FOR SECONDARY,A PRIMARY LEAK DETECTION SYSTEM MUST BE CIRCLED. <br /> I' / P 8 1 VISUAL CHECK P S 2 INVENTORY RECONCILIATION 3 VADOSE WELLS P 8 4 ELECTRONIC MONITOR P 8 5 GROUNDWATER MONITORING WELLS <br /> V P 8 6 PRECISION TESTING P 8 7 PRESSURE TESTING P A 91 NONE P 8 95 UNKNOWN P S 99 OTHER <br /> VI. INFORMATION ON TANK PERMANENTLY CLOSED IN PLACE <br /> 1. ESTIMATED DATE LAST USED(MO/YR) 2. ESTIMATED QUANTITY OF3.WAS TANK FILLED WITH <br /> GALLONS <br /> SUBSTANCE REMAINING IN INERT MATERIAL? ❑YES F] NO <br /> THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY,AND TO THE BEST OF MY KNOWLEDGE,IS TRUE AND CORRECT. <br /> APPLICANT'S NAME(PRINTED 8 SIGNATURE) DATE <br /> LOCAL AGENCY USE ONLY <br /> COUNTY M JURISDICTION• AGENCY# FACILITY ID# TANK ID N <br /> I a6 y e) I o <br /> CURRENT LOCAL AGENCY FACILITY ID N APPROVED BY NAME PHONE N WITH AREA CODE <br /> PEAMIT NUMBER PERMIT APPROV DN PERMIT EXPIRATION DATE <br /> OHECKN PERMIT AMOUNT SURCHARGEAMT.f FEE CODE RECEIPT# <br /> FORM a(s-zs-As) THIS FORM MUST BE ACCOMPANIECIAF AFACILITY/SITE APPLICATION, FORM `A',UNLESS A RENT FORMA' HAS BEEN FILED <br /> DATA PROCESSING COPY <br />
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