COMPLIANCE INFO_1986-2005 - Laserfiche WebLink

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D UNIFIED PROGRAM CONSOLIDATED FORM RECENEVN�S� UNDERGROUND STORAGE TANKS -TANK PAGE 1 TYPE OF ACTION ❑1.NEW SITE PERMIT ❑ 4. AMENDED PERMIT kV 5, CHANGE OF INFORMATION) PEE ENT RM (Check one item only) ❑ ❑3.RENEWAL PERMIT (SP« ,ssaaon-Lor local use o vy) (Specify cAenge•/or local lns onty) ❑ 8 TANK REMO'JED a BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 41 FACILITY IDR I 1 3 LOCATION WITHIN SITE(Options 431 I.TANK DESCRIPTION TANK 10 0 TANK MANUFACTURER COMPARTMENTALIZED TANK ❑ Yes No If'Yes'.complete one page for each compartment. #q , Stockton Manuf . & Sales DATE INSTALLED(YEARIMO) TANK CAPACITY IN GALLONS NUMBER OF COMPARTMENTS 1988 10, 000 gal ADDITIONAL DESCRIPTION(Forkscal use only) N/A 11.TANK CONTENTS TANK USE 4J2 PETROLEUM TYPE 1 MOTOR VEHICLE FUEL ❑Is, REGULAR UNLEADED ❑ 2. LEADED ❑ 5 JET FUEL (Il marked,complefe Petroleum Type) ❑It, PREMIUM UNLEADED 3. DIESEL ❑ 8. AVIATION FUEL ❑ 2 NON-FUEL PETROLEUM ❑ic. MIDGRADEUNLEADED ❑ 4 GASOHOL ❑99. OTHER ❑ 3 CHEMICAL PRODUCTryCAS 0(from Hazardous Materials Inventory page) COMMON NAME(from Hazardous Mafenals In"nlopage) ❑ 4 HAZARDOUS WASTE(Includes Used 09 111.TANK CONSTRUCTION TYPE OF TANK ❑ I, SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM (Check one item oM) 1P 2 DOUBLE WALL EXTERIOR MEMBRANE LINER C195. UNKNOWN ❑ 4. SINGLE WALL IN A VAULT [129. OTHER TANK MATERIAL-primary tank ❑ 1. BARE STEEL ❑ 3. FIBERGLASS I PLASTIC ❑ S. CONCRETE ❑95. UNKNOWN (Check ono item only) ❑ 2. STAINLESS STEEL 04. 51 EEL CUD W/FIBERGLASS ❑ 9. FRP COMPATIBLE W/100%METHANOL ❑99 OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL•secondary lank ❑ 1 BARE STEEL 3. FIBERGLASS f PLASTIC ❑ S. FRP COMPATIBLE W/100%METHANOL ❑95. UNKNOWN (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 LININGDATE INSTALLED OR COATING ❑ 1. RUBBER LINED ❑ 3. EPDXY LINING ❑ S. GLASS LINING ❑95. UNKNOWN433 ❑ 2. ALKYD LINING ❑ 4. PHENOLIC LINING N B. UNLINED ❑99.OTHER (For local use only) (Check one item or ) DATE INSTALLED OTHER CORROSION ❑ 1. MANUFACTURED CATHODIC 3. FIBERGLASS REINFORCED PLASTIC ❑95. UNKNOWN 434 PROTECTION IF APPLICABLE PROTECTION ❑99. OTHER ❑ <. IMPRESSED CURRENT (For local uss only) (Check ons item only) ❑ 2• SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED TYPE(Forlocal usa only) OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED (Check 89.1,h;,:ppfy9 ❑ 1. SPILL CONTAINMENT ❑ 1. ALARM ❑ 3. FILL TUBE SHUT OFF VALVE ❑ 2. DROP TUBE ❑ 2. BALL FLOAT ❑ 4. EXEMPT ❑ 3. STRIKER PLATE %W.`TANK LEAK DETECTION IF SINGLE WALL TANK MckeO but a IF DOUBLE WALL TANK OR TANK WITH BLADDER Check one item only): ❑ 1• VISUAL(EXPOSED PORTION ONLY) ❑ S. MANUAL TANK GAUGING(MTC) ❑ I. VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 2. AUTOMATIC TANK GAUGING(ATG) ❑9. VADOSE ZONE 2. CONTINUOUS INTERSTITIAL MONITORING ❑ 3. CONTINUOUS ATG ❑ 7. GROUNDWATER ❑ 3. MANUAL MONITORING ❑ 4. STATISTICAL INVENTORY RECONCILIATION(SIR)♦ ❑ S. TANK TESTING BIENNIAL TANK TESTING [Igo. OTHER V.TANK CLOSURE INFORMATION 1 PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) E8TIMATED OUANTTTY OF SUBSTANCE REMAINING 435 TANK FILLED HATH INERT MATERIAL? N /A Tgaffs ❑Yes ❑No er7 Formerly SV,/RCB Form B CUPAFORM(4/99)