COMPLIANCE INFO_1997-2002 - Laserfiche WebLink

Home Browse Search

(9k i t q--Q-i- Ahm UNIFIED PROGRAM CONSOLIDATED FORM "Woz- TANKS UNDERGROUND STORAGE TANKS-TANK PAGE 1 (two pages per tank) Page of TYPE OF ACTION ❑I. NEW SITE PERMIT ❑4. AMENDED PERMIT ®5. CHANGE OF INFORMATION) ❑6. TEMPORARY SITE CLOSURE (Check one item only) ❑7. PERMANENTLY CLOSED ON SITE ❑3. RENEWAL PERMIT [:]8. TANK REMOVED 430 (Specify reason-for Iotal use only) (Specify change-for loval use only) BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 FACILITY ID# Tosco Corporation#2611195/11195/30225 LOCATION WITHIN SITE(Optional) 431 L TANK DESCRIPTION (A scaled plot plan with the location ojthe UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# 432 TANK MZlo ACTURER 433 COMPARTMENTALIZED TANK ❑ Yes No 434 D�dB 701 f If'-Yes L,complete one page for each com rtm t. DATE INSTALLED(YEAR/MO) 435 TANK CAITACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 �a 000 I ADDITIONAL DESCRIPTION(For local use only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 1. MOTOR VEHICLE FUEL la REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL pjm ed,complete Petroleum Type) . PREMIUM UNLEADED ❑ 3. DIESEL ❑ 6. AVIATION FUEL ❑ 2. NON-FUEL PETROLEUM ❑le. MIDGRADE UNLEADED ❑ 4. GASOHOL ❑99. OTHER ❑3. CHEMICAL PRODUCT ❑ 4. HAZARDOUS WASTE(Includes COMMON NAME(from Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventorypage) 442 Used Oil) ❑95. XERXES III.TANK CONSTRUCTION TYPE OF TANK [:]1. SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 �2. DOUBLE WALL EXTERIOR MEMBRANE LINER [:]95. XERXES (Check one item only) ❑ q. SINGLE WALLIN A VAULT ❑99 OTHER TANK MATERIAL-primary tank [:]I BARE STEEL FIBERGLASS/PLASTIC ❑5. CONCRETE ❑95. XERXES 444 (Check one item only) ❑2- STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/100%METHANOL ❑99. OTHER REINFORCED PLASTIC FRP TANK MATERIAL-secondary tank ❑1. BARE STEEL >93 FIBERGLASS/PLASTIC ❑8. FRP COMPATIBLE W/100%METHANOL ❑95. XERXES 445 (Check one item only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑9. FRP NON-CORRODIBLE JACKET ❑99. OTHER REINFORCED PLASTIC(FRP) [:]10. COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING ❑ I. RUBBER LINED ❑3. EPDXY LINING ❑5. GLASS LINING ❑95. XERXES 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4. PHENOLIC LINING UNLINED [-]99. OTHER Check one item on/ For local use only) OTHER CORROSION ❑1. MANUFACTURED M& FIBERGLASS REINFORCED PLASTIC ❑95. XERXES 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE CATHODIC 4. IMPRESSED CURRENT ❑99. OTHER PROTECTION (Check one item only) ❑2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR IN T E 450 TYPE(For local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED �/�/;�452 (Check all that apply) TTTT�� . SPILL CONTAINMENT [:]1. ALARM . FILL TUBE SHUT OFF VALVE S. DROP TUBE ❑2. BALL FLOAT ❑4. EXEMPT STRIKER PLATE IV. TANK LEAK DETE TION (A description ojthe monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK(Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER(Check one item only): 454 ❑I, VISUAL(EXPOSED PORTION ONLY) E]5. MANUAL TANK GAUGING(MTG) [:11 VISUAL(SINGLE WALL IN VAULT ONLY) [J2. AUTOMATIC TANK GAUGING(ATG) E]6, VADOSE ZONE CONTINUOUS INTERSTITIAL MONITORING F-13 CONTINUOUS ATG [:17, GROUNDWATER 3. MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION(SIR), ❑8. TANK TESTING BIENNIAL TANK TESTING ❑99. OTHER V.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 Itallons l_i Yes Ir-1 No UPCF(1/99 revised) Formerly SWRCB Form B