COMPLIANCE INFO_1986-2000 - Laserfiche WebLink

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lame IC.aeapan i-- a Pp AQ—,, P a "00 9 2!000 Ca -1 -no %Grtitovl, Room 7-E050 "' Sart R'cwncel tip` zP94�?3 f2 Facillty c.c., r,>r*c J' Official Registration Form Califomia Water Resources Control Board Hazardous Substance Storage Statement ; who Must File: Eac!^ person storing nazaroous substances In any under the tank Wastes are included ground confampi must lite this form no later than July 1 1984 tAtter October Fee: For eacr, tans registered a $10 tee must be paid except that retail 1 1984 and no tater than January 1 1985 for tanks used on terms) gasoline stations pay $5 per tank Definition o1 Underground Containers: The taw applies to concrete - Penalfies: For failure to file the penally is $500.$5000 per day Ityou falsify sumps nonvauned cured tanks or other underground containers (Water information you can be fined up to $20000 to each day the information Is Code section 131731 All containers. including earthen waited pits ponds. Incorrect and has not been corrected lagoons and sumps that are below the normae ground surface level mist register A tank sitting on the ground is not Included Containers partially Confidentiality: if you have information protected by trade secret taws beneath the surface ate Included Lined or unlined pits ponds and lagoons please affect, a list of the Information on this tam that is confidential and the justification for r-onfidenhal4y Including specific citations of relevant sfatu are covered It earth has been removed from Ine storage area 10 construct toty and case law the facility Normal glading is not considered construction below ground Multiple Containers: Fit I and IJ on one form and leave n blank on all Ine level of Any suosla asted m Section 6382 of remaining forms Atlach as tams together securely If you Own more Irian 50 tanks you can file Information an computer tape Call 9161324.1262 to health of me Labor Code a to Semon 25316 of the kceaun and Safety Code This the Lan ode or ills ect.onSubs531 information Includes gasoline. diesel fuel all industrial solvents pesticides hem,ailles and fumigants II the material must be carried by a registered hauset. dis This In not a Permit Application. All underground Tanks will be subleci To posed of at a nazaroous waste site ,s explosive generates pressure due to local regulation Some Iurlsdlctlons nave already begun programs Chec, heal or decomposition 01 would harm humans or wildlife you must register with your local county government tot further Information NOTE: ALL UNDERGROUND CONTAINERS MUST REGISTER EVEN IF STATE AND/OR LOCAL PERMITS ARE IN FORCE. I Owner lame IC.aeapan i-- a Pp AQ—,, P a "00 9 2!000 Ca -1 -no %Grtitovl, Room 7-E050 "' Sart R'cwncel tip` zP94�?3 f2 Facillty c.c., r,>r*c Dealp: caemar. supnrsa r q V C+ , G Pacific —0'70 C. Year Installed 1q1� O Unknown smear A4aoss Naares� Cross Srer 1?,4 Wr-s-r EL'th STR-L-T North Cht+r cd, Street :-aa carat/ IIP Lzt % AH -So eilgk1lN RS141 as>wnp.oaesa 44- west yotuts Street 399- Pirir ca, 5toC-icrorl spa Zip 952 07 Pna.e. pea cone 209) 474 - 4377 Da Motor Ovehicle Fuel Station Was Other -SIC _4$0Q N.— a Tara! a, •nK raMh Rural Are; T4anSnw Barye seu— I Only: III 24 Hour Emergency Contact Person Cars game rws• risme nisi. arae Wane n area cwe 415 - 122 3 . -7777 h. jr, Name lest Nine IaS:r Arlo Phone . Are. code Q 1 �✓- - 8 2 3 - 7 7 7 7 Emergencv Control Center COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER IV Description A Uzi Tank O tie Sump O 03 Lagoon Pit or Pond O a Other eoiswle.r taaawr III mere s no re,Roeassn^ •M, 8 Manufacturer (if appropriate) Ilhkxnnwn Year of Mtg: l)r,ltndwn C. Year Installed 1q1� O Unknown D Contain-, Capacity —SQL= gallons O Unknown E Container Repairs O or None iii o2 Unknown O oo Yes Year F Is Container currently used) Uo- Yes Do? No It No. year of last use O o, Unknown G Does the Container Store (Check One) O o, Waste ® o2 Product H Does the Container Store Motor Vehicle Fuel or Waste Oil? 61or Yes Ow No It Yes Check appropriate box(esi O or Unleaded O o2 Regular O oo Premium Jkoa Diesel O Its Waste Oil O ok Other (List1: V Container Construction A Thickness of Primary Containment O Gauge O Inches O cm W Unknown 8 O or Vaulted (Located in an underground Vault.) SI o2 Non -vaulted O 1,3 Unkncwn C O or Double Walled as c2 Single Walled O r» Lined O its, Unknown O os None D Aa Carbon Steel O at Stainless Steel O oo Fiberglass O M Polyvinyl Chloride O as Concrete O ro Aluminum O or Steel Clad O tie Bronze O os Composite O to Non-metallic O it Earthen Walls 12 Unknown 0,3 Other E O of Rubber Lined O o2 Alkyd Lining O oz Epoxy Lining O w Phenolic Lining O in Glass Lining O os Clay Lining e r Unlined Q a 61ilklue nott O w Other: F 0 or Polyethlene Wrap 0 o• Vinyl Wrapping 0 a Cathodic Protection dol, Unknown Os None