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OHictai ..egistratlon Form <br /> ® California Water Resources Control Board <br /> *azardous Substance Storage Staterst �'tr <br /> who Must F": — <br /> Poe. <br /> Do"won at undervirvillow Contrnerc _iz _ ss :•s_ _ .. <br /> s. .a.:e. •e:'s-•s ;,ral,cn ,c.can;, '"i: „520.^CC a•s:��:r.cite ...^aror• s <br /> Cooeasection tat 731 Aa Cawsner; rnCWOng®annon wawa ate pans w4orrw aro nae not ow cancteo <br /> 'agoan Ono SUMPS In”are pillow IM norm"ground surface"vel'muss Conditgnellicify If you nave -ormation protKteo trade secret laws <br /> ® tagistr A tank siring on me ground to riot+Kkrded CORISOWS partially pease anacn a 4st Of:ne.n ormakat on Irks form Millis eontroermaf ire Iretkrim m@laeurekaC+ <br /> are nuded UneO a trwrusv ars conics afiigoafs lusidk:atrorn rot Confidentiality Kkepkug scoof c cflatrona Of rargv*rw SMU- <br /> are coverao A earn has Dean removed from int storage area to construct tory aro case is- <br /> me tacukty normal WO" 4 rip+conS4WOO COnW CIIW oatow grdund Yt �ieFri i aro Uon ane ram ono leave.t sink On ori troe <br /> efi <br /> ever!ever en M AM fuDflinCf listed�n SKIWn 831$2 rerrtiehr�tams Artach as tams togemor sec.jr" r you own more mar, <br /> of!"LaDa Code a�n SeCl on 25318 of me mileahn Oro Safety Coo* Tris 50 tanks you un oke,rgamakon Ori Computer tape Cori 916 32`•1262 rot <br /> information <br /> •-vuoes gasoline esr Aro. an Industrial solvents PSSDCidef Mortician <br /> a <br /> aro turrnrgarwS it me Maier"must De Carroo Dy a register d naWef as- 77ft Is nal a►erwW AopftoftM AN Underground Tanks ors x su,epti'o <br /> 00 ea of at a nszardous waste site s ex iovve generates pressure due to focal regulation Some ,urisorct a»nave akeady gun � <br /> beproims Check <br /> neat or decomposflWn or Moto norm humans or wkfyre you must register Mtn your WCL County gowe'rrir+efw ria furhef information <br /> aaTL- ALL UPIMaPOUND CQMTAINaRS MUST Raf3tSTMR aver•STATa AMO/011111 Loci PUM"ARM IN FORcs. <br /> I Owner _ <br /> U.S. ggv2rnM2nj <br /> ..... <br /> W"Acit sw rot <br /> 1 <br /> ® Fecoty <br /> ..c.y t>r.w.r..w.�.... <br /> Lawrence Lly=rc National La tory - tp 100 <br /> sow agew .r..cilia sn.w <br /> Corral Follow Road %-580 <br /> Cw C4." z» <br /> South of Tracy San Joa uin <br /> ® eak.iq-elite.® cul am zW <br /> Post Office Box 808 Livermore Ca 94550 <br /> -we.,.rqxnev, Test Facility <br /> 415 422-5174 oil Mote veftide FUM Staten Cha Othter <br /> w T3g..,rasr, y..s. s.00 <br /> T3S HE <br /> III 21 <br /> oavi; . ftv"ftilikil,1-40"W"", P.M..Skills COO, <br /> Gonzalez, Marjorie 415 422-5174 Sharry, John 415 422-7333 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV Desicillpeoln <br /> ® A Clo,Tank ❑a Stump ❑m Lagoon.Pit or Pond ❑ Omer 815-11 D <br /> 8 Manufacturer(w appropnatet year of k*g. C Year irt�tsaeQ 1959 C unknown <br /> I <br /> D Container Capscayl QiQ gal" ❑Unknown E. Conafner Repaes-43 or Nora O a unknown O m yes Year <br /> F is Container currency usedl yes O a No It No,year of last use Coo unknown <br /> ® G Coes the Corwsrla Store(Check One1 Co,waste (&a Product <br /> H Does the Contairw Store x Uel Of Waste Ods kw yes ❑n Nci if Yes Check appropriate Dox(es) <br /> O o. unleaded ❑a Regular O to Premium C1 a-Onset O its waste oil ❑n other(Usti <br /> V Contalnsr Construictlon <br /> A Thickness of Primary Containment O Gauge ❑inches O cm )t.;unknown <br /> 8 ❑oI vaulted(Located in an underground Vault 1 0 a Non-vaulted O m Unknown <br /> C C,, Double waited 2 cz Single waited 0.3 Lined M o.wrapped ❑n unknown ❑x None <br /> 0 C17. Carbon Steel ❑u Stainless Steen ❑)1 Fiberglass ❑o+Poiyvfnyi Chloride C n Concrete ❑:o Aluminum <br /> ® O r Steel Clad O y,Bronze O.4 Composite O•0 Non-metallic O •Earthen waits <br /> ❑ Unknown ❑ ,Other <br /> E O RuODer Lined ❑.2 Alkyd Lining O :Epoxy Lining ❑..PnenotfC L ring O .Glass Lining ❑ 6 C:av Lining <br /> I <br /> ao'Unlined O Ie Unknown O-a Other <br /> ® F O.� Polyetniene wrap 0:Vinyl Wrapping ❑ Cathodic Protection C r UnknCwn C None c% .Olney TarWra gped <br />