COMPLIANCE INFO_1985-1993 - Laserfiche WebLink

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Official Registration Form California Water Resources Control Board .. Hazardous Substance Storage Statement i Who Must File:Each person storing hazardous substances in any under the tank wastes are Included ground contatnet must file flys form no later than July 1 1984 tAher Oc:oDer Fee: For each lank registered a SID fee must De paid except that retail 1 1964 and no fate,man January 1 1985 for tanks used on farms) gasoline stations pay$5 per tank Dri initlon of Underground ContNners: The law applies to "concrete Penalties:For failure to file the penalty is$500-SS Got,per clay if you faisay sumps nonvaul ell bulled tans or other underground containers (water Information you can be tired up to$20000 tot each day Inti rma Infot,on is Code seci,on 131731 All containers including earthen waned pts ponds incorrect and has not been corrected lagoons and sumps mat are veto*the normal ground Surface:ever must Confl"nYallty- If you nave Information protecled by trade secret taws reg,ste, A tank sitting on the ground,s nor included Containers partially please attach a list of the information on this form that is conldem,at and the beneath the surface are included Llhed or unlined pts ponds and lagoons justification for r-onfidemat4y Including specific citations of relevant staiu- are covered it earth has been removed from:rte storage area to construct Idly and case law the facility Normal grading Is rot considered construction below ground level Multiple Containers:Fat I and II on one form and leave 4 piano on all the Detinttlon of Nasardous$ubstmlkc ,An substance listed m Section 6382 remaining forms Attach an forms iogelnet securely d you own more than d the Labor Code or m Seci•on 25316 o Any Hearin and Safety Cone This 50 tanks you can file Information on computer tape Can 916%324 1262 for tion includes gasoline o,esei luef as Industrial solvents pesticides heroicides his Is not and fumigants if the material must be carried by a registered hauler d,5- TMs Is not a Fermat Apptiutbn.All Underground Tanks dal ce SUDIec1 to posed of at a hazardous waste site is explosive generates pressure due to fora:regulation Some jurisdictions nave aueady begun programs Cnecx heat or decomposition or would harm humans or wildlife you must register with your focal county government tot further Information NOTE: ALL UNDERGROUND CONTAINERS MUST REGISTER EVEN IF STATE AND/OR LOCAL PERMITS ARE IN FORCE. I Owner x.n a Iea,aran,na.ra,r a PA.4Wncrl PACifir. Bell "0 , Z(Oco Carrlono IZC%vnOn, Ooom ZE.050 0' San Ramon sive zlP94SOS II Facility recw.•,Pme parr,caemrnS,.ne,.�so• R. SAtIAG�G Pacific res,Gns Sn �, Seta Sf�gfZVl;nt Lindsay Z rl, �„ canxy jIP STOut-r®N Sc�taSoa '1Lint QS 101 ""' 44 West VCkLOS Street "" Stoc-kio✓a yr° ZIP 952o-7 -3-'T"h-ixd--Street Pryor r•-dol,(Zo q) 47, 4 3 7'1 Oa Motor Venicfe Fuel Station �1o2 Other SIC 4811D. N,.mon a temp aI m..racwr Rural Argas re.m6rw A"`qe Se°w till Only: III 24 Hour Emergency Contact Person Corti,'..ml,INT Mme ill,xr10 PItOIN a re.coir 4 i 6_ 023 - -77 7 Z N�pn/!N.mp IIPfI MM Isrl MO PMI+'w rCe L'i0P 4%r, 1r, O nL S _ 7-7 7 7 Emergency Controln -+15-542-4601 L COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER IV Description 5 E E F 0 LL 0 w c N 6 P A CTE S carinal. A O Tank O o2 Sump Cc)lagoon.Pit or Pond O a Other B. Manufacturer(if appropriate) Year of Mfg.. C Year Installed: O Unknown D Contain—Capacity gallons O Unknown E Container Repairs 0 of None O o2 Unknown O o3 Yes Year F Is Container currently used) O o,Yes O o2 No If No.year of last use O o3 Unknown G Does the Container Store(Check One) ®o,Waste O w Product H Does the Container Store Motor Vehicle Fuel or Waste Oth Dot Yes Oof No it Yes Check appropriate box(esi O o,Unleaded O o2 Regular O 03 Premium O o.Diesel O os waste Oil O os Other(List) V Container construction A Thickness of Primary Containment O Gauge O Inches O cm O Unknown B O a,Vautteo(Located in an underground Vault 1 ❑o2 Non-vaulted O 03 Unknown C O w Double Walled O o2 Single Walled O to Lined O o.Wrapped O m Unknown O a None D O o,Carbon Steel O oz Stainless Steel O 03 Fiberglass O N Polyvinyl Cnlorrdq O os Concrete O oe Aluminum Doi Steel Clad O Ie Bronze 0,,-Composite Div Non-metallic O it Earthen Walls O v Unknown 0.3 Other E Do,Rubber Lined O o2 Alkyd Lining O o3 Epoxy lining O a Phenolic Lining O m Glass Lining O o.Clay Lining O o•Unlined Coe Unknown O as Other F C.,Polyethfene Wrap Cc Vinyl Wrapping O c3 Cathodic Protection 0 N Unknown 0 os None 0 vs Other