Laserfiche WebLink
FROM (THU)JUN 10 2004 12' ` /ST. 12 :27/No. 68079h 510 6 <br /> L ►� PSR s v� <br /> UNMED PROGRAM CONSOLIDAnD FORM 9 , <br /> T KS �. <br /> UNDERGROUND STORAGE TANKS -TANK PAGE l 1 ` <br /> (two paf5c t>a tank)k) °~ <br /> u <br /> P4a„`�,of 1rZ <br /> TYPE OF ACTION ❑1 NEW$ITE P17RMIT Q 4 AMENDED PERMIT Q 5 CHANGE OF INFORMATION L36 TEMPORARY SITE CLOSURE \A\ <br /> (Clink-ikmmb') Q 7 PERMANENTLY CLOSED ON SITE <br /> ❑ 3 RENEWAL PERMIT (Specify rbs lout use only) (Sm*n n -%Iow1 we o,*) ❑ 8 TANK REMOVED 430 <br /> BUS INFSSNAME(SenruFACILITY NAW mDBA-Doing Busircssu) _ FACILITYID: LL_j I <br /> LOCATION WITIAIN SITE mpt_d) 431 <br /> 1.TANK DESCRIPTION (A scaled plot plan With the location of the UST system including buildings and landmark%shall be suhmitted to the Iopsl ageltcy.) <br /> TANK ID# 452 TANK MANUFACTURER Q7 COMPARTMENTALIZED TANK Y.JTNo 434 <br /> l/ a Z S Ir-Ym•,00tleW414 owe l+sw rw.esh cmwm,ww. <br /> DATE INST E (YEAR/M0) 4s4 TANKxCAPACITY W GALLONS 436 NUMBER OF COMPARTMENTS 4n <br /> ADDITIONAL DESCRIPTION(Fm tool ux only) pa <br /> li.TANK(:ONTENTS <br /> TANK USE 439 PETROLEUM TYPE 440 <br /> 1. MOTOR VEHICLE FUEL [I[&. REGULAR LJNLF-AD90 QDED ❑5. JET FUEL <br /> (Umukedw pleb Rtrvi nType) ❑Ib. PREMIUM UNLEADED 3. DIESEL ❑6, AVIATION FUEL <br /> ❑2.NON-FUEL PETROLEUM ©Io. MIDGRADE UNLEADED Q 4, OAS01401, ❑99.OTHER <br /> ❑3. CHEMICAL PRODULT COMMON NAME(6om H..d.Mmuuls hwmsmy page) 44� CASN(fi m ILmdaa Mamas Invoi y1)%e) <br /> ❑4. HAZARDOUS WASTE (� / <br /> (imiudgslMMOd) .'„ �n X ?( .f <br /> [193.UNKNOWN hJ W1 lY V ���CCC 1 <br /> JUL TANK CONSTRUCTION <br /> TYPE OFI'ANK I. SINGLE WALL 3. SINGLE WALLWIT14 5. %rwi.I?WALL wITHrNwRNAT,IILADOFP,SYSTEM 443 <br /> (Cheek aee item only) EXTERIOR MEMBRANE LINER ❑95,UNKNOWN <br /> 2. DOUBLE WALL ❑4 GNLE WALL IN VAULT ❑99. OTHER <br /> TANK MATERIAL_prinwy wk 1. BARE STEEL 533, FIBERGLASS/PLASTIC 5. CONCRETE LJ95. UNKNOWN 444 <br /> ❑2. STAINLESS STEEL (34, STEEL CLAD W(FIBEROLASS ❑5. FRP COMPTIBLE W11009E METHANOL Q 99.OTIIPR <br /> INFOPCED PLASTIC(FRP) <br /> TANK MATERIAL-secmdrytmk 1. BARE STEEL 3, FIBERGLASS/PLASTIC U 5. CONCRETE U 95. UNKNUWN 44} <br /> (Cheek o-ft.o*I ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBP.RGLASS ❑8. FRP COMPTLBL.E W/100%METHANOL Q 99.0"IFR <br /> REINFORCED PLASTIC(FRP) ❑10.COATED STffi. <br /> ❑5. CONCRETE <br /> TANK INTERIOR LINING 0 1,RUBBER I,INFA U 3.EPDXY LINING C 5. LASS LINING 95.uNKNowN 446 DATE INSTALLED 443 <br /> OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING Ly"6 UNLINED ©99 OTHER <br /> (Check one ibn aJy) (vo.ioal uAe o°ly) <br /> OTHER CORROSION ❑l MANUFACTURED CATTIODIC ❑3 FIBERGLASS REINFORCED PLASTIC 95 UNKNOWN 448 DAT£INSTALLED 449 <br /> PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT O 99 OTHER <br /> (Cheek me ii moan) ©2 SACRIFICIAL ANODE (Pu bw eee-N) <br /> SPILL AND OVERFILL YEAR INSTALLED 430 TYPE(lout..*) 451 OVERFILL PROTECTION EQUIPMENTNEAR INSTALLED 451 <br /> (Ctkck sll h"Apply) Q I SPII,I,CONTAINMFIJT Q 1 ALARM Q 3 FILL TUBE SHUT OFF VALVE <br /> 7DROP TUDE 0� ❑2 BALL FLOAT El MMMPT <br /> 3LTJ 3 STRIKER PLATE <br /> IV.TANK LEAK DETECTION(A dezagcm ordse mawwriP4 pgpm slrA be sobm W to ion)orA agm y.) <br /> IF SINGLE WALL TANK(Feed a thm wply) 4S3 IF DOUBLE WALL TANK OR TANK Wff.li 6LAIR&R 454 <br /> ZZ <br /> C3 VISUAL(EXPOSED PORTION ONLY) C:)5 MANUAL TANK GAUGING(MTG) r2CChIMNUOUS <br /> UAL(SINGLE WALL IN VAULT ONLY) <br /> ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE INTERSTITIAL MONITORING <br /> D 3 CONTINUOUS ATG Q 7 GROUNDWATER ❑3 MANUAL MON[TORINO <br /> ❑4 STATISTICAL INVENTORY RECONCILIATION ❑a TANK TESTING <br /> (SIR) BIENNIAL TANK TESTING ❑99 OTHER <br /> IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USED(YR/MO/DA Y) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 4S6 TANK FILLED WITH PIRRT MATERIAL? 457 <br /> gallons ❑Yes ❑ No <br /> UPCF(12/99 revised) 10 Formerly SWRCB Form 8 <br />