COMPLIANCE INFO_2011-2018 - Laserfiche WebLink

Home Browse Search

09/25/2009 13:13 2094749151 HAMMER I5 ARCO PAGE 04/16 UNIFIED PROGRAM CONSOLIDATED FORM D �,. ''z c' UNDERGROUND S'T'ORAGE TANK OPEMitem TING PERMIT APPLICATION-TANK INFORMATION (One form per UST) TYPE OF ACTION (Check ononly. ,For a UST Closure or removal,complete only this section and Secriow I dI,IV,,IV,,and,1,,Ybelow) �0 ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT 0 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE El 8.UST REMOVAL 43MDATE UST PERMANENTLY CLOSED: DATE EXISTING UST DISCOVERED: FACILITY ID#(Agency Use Only) ) ) N S7S BUSNUS NAME(Same as Facility Name or DBA-Doing,8usi M As) Hammer/I-5 Arco BUSMSS SITE ADDRESS 103' CITY la. 3250 W.Hammer Lane Stockton TAMC iI}# a32 TANK MANUPACTT777NUM IGURATION:TEAS TANK IS a;4-Tq 2 - -ALONE TANK Complete o4W pap far cash Owens A COWARTMENTED UNIT -is e-�. DATE UST SYSTEM INSTALLED 433. TANK CAPACITY IN GALLONS 4� COMPARTMENTS IN THE UNIT 437. 1985 1 12 000 1 1 i TANK USE ® la MOTOR V==Fu=JNG [3 ib.MARINA I'UGLLKG D io.Av1ATtOr1 FUFsL1NG 439, ❑ 3.CHEWCAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(IN hwu V"d OSq ❑ 5.EMERGENCY GENERATOR FUEL{HSC P5281.5(b3] _❑ 6.VrH A GENa1z TOR I IS1vt _0 95.UNM4OWN _ ❑ 99.OTHM S 1 -- CONTS TENPETROLEUM: w 0 I a.REGULAR UNLEADED ❑ lc.M DGRADE UNLEADED ❑ Ib.PREIvfIUM UNLEADED 440• ❑ 3.DIESEL ❑ 5.JET FUEL Q 6.AVIATION GAS ❑ s.F'E'£I QkRLU BLEND FUEL ❑ 9.OTi�x_PETROLSUM(SV-ify�_ 44oa --- -- 1`FON-PETROL EUM:[37.USED OIL I0.ETHANOL M~n 1311.OTHER NON-FETROLPUM S " ' RIM almalm"44 'r 443. t. TYPE OF TANK ❑ 1.SINGLE WALL 10 2.DOUBLE WALL ❑ 95.UNKNOWN _ PRIMARY CONTAINMENT ❑ Ls 0 3.FIBERGLASS d 6.II�tf AL ALADAER N 444' _ _ _ _C3 7.STEEL+INTERNAL LINING _ ❑ 95.LTNM40WN _ 99.OTHER(Specify): _. °dam'• SECONDARY CONTAINIv NT ❑ 1.STEEL T 19 3.F7�lERGLASS ❑ 6.EXTERIOR N EM13RANE LINER ❑ 7.JACKETED 446, ❑ 90.NONE 0 95.UNKNOWN ❑99-OTHER 445a OVERFILL PItEVI NTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ Z.BALL FLOAT 0 3.FILL TUBE SHUT-OFF VALVE 452. 0 4,TANK MIMTS RE IJLRbMENIs POR Fm YON FR()ht OVERFILL PREVENTION E i3IPMENT PIPING CONSTRUCTION ❑ 1.SINGLE WALL.0 2,DOUBLE WALL ❑ 99.0 _ _ 460 SYSTEM TYPE ® f.PnisSurtE�Q?_ FA,VITY El3.CONVENTIONAL SUCTION E3 4.SAFE SUCTI0na; c a s 455. PRIM4RY CONTADWEN'T ❑ 1.STEEL r- 0 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC �• ❑ 90.NONE ❑ 95.UNKNOWN El 5 i£y: 464s SECONDARY CONTAINMENT 13t.STEEL 0 4.M17A LASS ❑ 8.FLEXIBLE ❑ 10.RIGIDPLASTIC 464b. _ M 90,NONE ❑ 95.UNKNOWN 0 99.OTHR( 464`. PIPINarruRBINE CONTAIN hMNT SUMP TYPE 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE 464& VENT PRIMARY CONTAINMENT ❑ I.STEEL ® 4.FRGLASS� ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify), 446401: VENT SECONDARY CONTAINMENT El1.STEEL E34,FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE C3.99.OTM(Spaicj 464tI, VIZ_P_RIMARY CONTAINMENT [4 i.STEEL ❑ 4.F703Fa12GLASS Y-13I0.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(SPecify); VIZ SECO_NDARY CONTAINMHNT' C1 I.STEEL © 4.FIJ31 ROLASS ❑ 10.RIGID PLASTIC 090.NONE ❑ 99.OTI4ER(SP¢oify): 464b1. VENT PIPING TRANSTT10N SUMP TYPE_ ❑ i.SINGLE wALL�❑ 2 DOUBLE WALL ® 90,NON< RISER PRIMARY CONTAINMENT N 1.STEEL. ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC~ ❑ 90.NONE ❑ 99.OTHER(Specify): 46411. RISER SECONDARY CONTAIlVMENT ❑ 1.STEEL [34.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE ❑ 99.OTHER(Specify): 464kd. FILL COMPONENT$INSTALLED R9 1.SPILL BUCKET 0 3.STRIKER PLATEMOTTOMPROTECTOR ® 4.CONTAINMENT SUIS d5i� , I CONS'T'RUCTION TYPE _ 0 1.S1NGI.I:WALL O 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.xG� a 46a� 9b. CONSTRUCTION MATERTAL� ❑ 1.STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Spec*) „ PCERIT�MMCA OMPONENT PROTECTION ❑ 2.SACRIFICIAL ANOD s ❑ 4.DeRESSED CURRENT 6.LSOL.ATION d48 EIR M14 TTON: Icer4l�y that this UST system is conepgdble with the haxardoas substance stored and that the information pr0vid n is tone, accurate and in au eom nce wltbl 1 al uirements. APPLICANT sIGNATURR DATE 9/2 /2009 azo. 471• APPLICANT TITLE Ori APPLICANT NAME(print) We ey Parkinson Owner UPCF UST-B Rev.(JZ7A7)-1/2 www.unidocs.org