BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

l.1 STATE OF CALIFORNIA �1 W �° °Os, STATE WATER RESOURCES CONTROL BOARD I�JY� UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B W �� ue Id" COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM MARK ONLY ❑ 1 NEW PERMIT O 3 RENEWAL PERMIT 5 CHANGE OF INFORMATION O 7 PERMANENTLY CLOSED ON SIT[ ONE ITEM O 2 INTERIM PERMIT O 4 AMENDED PERMIT 6 TEMPORARY TANK CLOSURE ® 8 TANK REMOVED of DBA OR FACILITY NAME WHERE TANK IS INSTALLED: Di S IVO Trucking Co. ❑ 3 FIBERGLASS O 4 STEELCLAD W/ FIBERGLASS REINFORCED PLASTIC I. TANK DESCRIPTION COMPLETE ALL ITEMS-- SPECIFY IF UNKNOWN A. OWNER'S TANK I.D.# B. MANUFACTURED BY: Unknown C. DATE INSTALLED (MCJDAY/YEAR) unknown I D. TANK CAPACITY IN GALLONS: 12 r 000 ILTANKCONTENTS IFA-( IS MARKED. COMPLETE ITEM C. A JI 1 MOTOR VEHICLE FUEL E]4 OIL 8. C. [-]/.UNLEADED GULAR ® 3 DIESEL ❑ 6 AVIATIONGAS r❑ 2 PETROLEUM ❑ 80 EMPTY 1 PRODUCT ❑ ib PREMIUM 4 GASAHOL 7 METHANOL ❑ 2 STAINLESS STEEL ❑ 3 FIBERGLASS O 4 STEELCLAD W/ FIBERGLASS REINFORCED PLASTIC UNLEADED ❑ L 3 CHEMICALPRODUCT ❑ 95 UNKNOWN ❑ 2 WASTE ❑ 2 LEADED ❑ 9 9 OTHER(DESCRIBE IN ITEM D. BELOW) D. IF (A.1) 15 NOT MARKED. ENTER NAME OF SUBSTANCE STORED ❑ 99 OTHER 4 FIBERGLASS PIPE 8 100% METHANOL COMPATIBLE W/FRP 99 OTHER C. A. S. # III. TANK CONSTRUCTION MARK GNP ITFM ONI Y IN RO%FS A. R. ANO C AMI Al I TWAT APPI IFS IN RnY n ..n I= A. TYPE OF ❑ 1 DOUBLE WALL ❑ 3 SINGLE WALL WITH EXTERIOR LINER ❑ 95 UNKNOWN SYSTEM ® 2 SINGLE WALL ❑ 4 SECONDARY CONTAINMENT (VAULTED TANK) ❑ 99 OTHER B. TANK ® 1 BARE STEEL ❑ 2 STAINLESS STEEL ❑ 3 FIBERGLASS O 4 STEELCLAD W/ FIBERGLASS REINFORCED PLASTIC MATERIAL ❑ 5 CONCRETE ❑ 6 POLYVINYL CHLORIDE ❑ 7 ALUMINUM O 8 100% METHANOL COMPATIBLE WIFRP (Primary Tank) ❑ 9 BRONZE ❑ 10 GALVANIZED STEEL ❑ 95 UNKNOWN ❑ 99 OTHER 4 FIBERGLASS PIPE 8 100% METHANOL COMPATIBLE W/FRP 99 OTHER O 1 RUBBER LINED O 2 ALKYD LINING O 3 EPDXY LINING O 4 PHENOLIC LINING C. INTERIOR ❑ 5 GLASS LINING lil6 UNLINED ❑ 95 UNKNOWN ❑ 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_ NO— D. CORROSION ❑ 1 POLYETHYLENE WRAP Q 2 COATING 3 VINYL WRAP ❑ 4 FIBERGLASS REINFORCED PLASTIC PROTECTION ❑ 5 CATHODIC PROTECTION ❑ 91 NONE ❑ 95 UNKNOWN ❑ 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION p 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A0 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION A A U A U 1 BARE STEEL 5 ALUMINUM 9 GALVANIZED STEEL A U A U A U 2 STAINLESS STEEL A U 6 CONCRETE A U 10 CATHODIC PROTECTION 3 POLYVINYL CHLORIDE (PVC)A U 7 STEEL W/COATING A U A U 95 UNKNOWN A U 4 FIBERGLASS PIPE 8 100% METHANOL COMPATIBLE W/FRP 99 OTHER D. LEAK DETECTION ❑ 1 AUTOMATIC LINE LEAK DETECTOR lxl2 LINE TIGHTNESS TESTING ❑ 3 MONITORING ❑ 99 OTHER V. TANK LEAK DETECTION ❑ 1 VISUAL CHECK ❑ 2 INVENTORY RECONCILIATION 3 VADOZE MONITORING ❑ 4 AUTOMATIC TANK GAUGING ❑ 5 GROUNDWATER MONITORING 6 TANK TESTING O 7 INTERSTITIAL MONITORING ❑ 91 NONE ❑ 95 UNKNOWN ❑ 99 OTHER 1. ESTIMATED DATE LAST USED(MO/DAYIYR) 2. TAATED QUANTITY OF 1D0 GALLONS 3 WASNERI MATED WITH 31.1192 YES ❑ NOY:] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PE URY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANTS NAME {. DATE (PRINTED A SIGNATURE( JohS. Tunger r 3/5/92 LOCAL AGENCY USE ONLY THE STATE I.D. NUMB I OMPOSED OF THE FOUR NUMBA BELOW COUNTY # URISDICTION # FACILITY # TANK # IS41-14 STATE I.D.# 6 fs 6 k PERMITNUMBER PERMIT APPROVED BY/DATE – PER MITE%PIRATIONDATE (`—Ill 173 `IZ_1/3 FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION • FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED