COMPLIANCE INFO_2002-2006 - Laserfiche WebLink

Home Browse Search

f IED PROGRAM CONSOLIDATED FORib TANKS UNDERGROUND STORAGE TANKS-TANK PAGE 1 (two pages per tank) Pape _ of TYPE OF ACTION ❑1.NEW SITE PERMIT ❑ 4. AMENDED PERMIT ❑ 5. CHANGE OF INFORMATION) ❑ S. TEMPORARY SITE CLOSURE n/ tCheck one dem ONy) ❑ 7 PERMANENTLY CLOSED ON SIT ❑3.RENEWAL PERMIT (Specify/eason-for local as only) (Spocdy change-forlocel use oN)) ❑ 8. TANK REMOVED 430 BUSINESS NAME(Same as FACILITY NAME or RBA-Dong Business As) FACILITY 10 0 ,gppo/v '65IvTEhPR15F ,�yrc. DHr}: cwt M LOCATION WITHIN SITE(OptiolleQ 43t 3W 3 s. cwms *IRvA� rw fe, c4. 953716 1.TANK DESCRIPTION TANK 10 tf TANK MANUFACTURER C40MPARTMENTAUZED TANK if Yes ❑ No 0 wu,complals one pays for each compartment DATE INSTALLED(YEARtM ) ./ TANK CAPACITY IN GALLONS ,_J,�.X2 NUMBER OF PARTMENTS ADDITIONAL DESCRIPTION(For local use Onry) II.TANK CONTENTS TANK USE 432 PETROLEUM TYPE 1. MOTOR VEHICLE FUEL w❑Ia. REGULAR UNLEADED / �` ❑ 2. LEADED �y'y�,G ❑ 5 JET FUEL (n rn+aed comPtete Parrolaum Type) IJp t C PREMIUM UNLEADED �j s'J 3 DIESEL �j{�/v'7 ❑ d AVIATION FUEL ❑ 2 NOWFUEL PETROLEUM /❑'�1c. MIDGRADE UNLEADED ❑ 4.GASOHOL ❑99 OTHER ❑ 3.CHEMICAL PRODUCT CASH(/mm Haxendous Materials lnventorypege) COMMON NAME(no/n Haiardous Materials Imm.tory page} C3 4. HAZARDOUS WASTE(Includes Used Oil! n 95 UNKNOWN IN.TANK CONSTRUCTION TYPE OF TANK ❑ 1. SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM (Check one item ONY) 2 DOUBLE WALL EXTERIOR MEMBRANE LINER ❑95. UNKNOWN ❑ 4. SINGLE WALL IN A VAULT ❑gg. OTHER TANK MATERIAL-pnmwy tank ❑ 1 BARE STEEL 3. FIBERGLASS I PLASTIC ❑ 5. CONCRETE ❑95 UNKNOWN (Check one Item only) ❑ 2. STAINLESS STEEL ❑4 STEEL CLAD WIFIBERGLASS ❑ 8. FRP COMPATIBLE W1100%METHANOL ❑99. OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL-secondary tank ❑ 1 BARE STEEL ❑ 3. FIBERGLASS I PLASTIC ❑ 8. FRP COMPATIBLE W1100%METHANOL ❑95. UNKNOWN (Check one item only) ❑ 2. STAINLESS STEEL ❑4. STEEL CLAD WIFIBERGLASS ❑ 9. FRP NON-CORRODIBLE JACKET ❑99. OTHER REINFORCED PLASTIC(FRP) 010 COATED STEEL ❑ 5. CONCRETE TANK INTERIOR LININGDATE INSTALLED OR COATING ❑ T RUBBER LINED ❑ ]. EPDXY LINING ❑ 5. GLASS LINING ❑95. UNKNOWN433 ❑ 2. ALKYD LINING ❑ 4. PHENOLIC LINING W6. UNLINED ❑99. OTHER For local"a oN) (Check one dam only) DATE INSTALLED OTHER CORROSION ❑ T MANUFACTURED CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN �434 PROTECTION IF APPLICABLE PROTECTION ❑ 4. IMPRESSED CURRENT )(99.OTHER (Forfocat use only) - (check we dam only) [032. SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED TYPE(For Wal use onW OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED (Cneck ON that app1Irl X 1. SPILL CONTAINMENT ❑ 1. ALARM 3. FILL TUBE SHUT OFF VALVE 2. DROP TUBE ❑ 2. BALL FLOAT ❑4. EXEMPT 3. STRIKER PLATE N. TANK LEAK DETECTION IF SINGLE WALL TANK Check ad Mat ): IF DOUBLE WALL TANK OR TANK WITH BLADDER Check one item ): ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5. MANUAL TANK GAUGING(MTG) ❑ 1. VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 2. AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE 2. CONTINUOUS INTERSTITIAL MONITORING ❑ 3. CONTINUOUSATG ❑ 7. GROUNDWATER 3. MANUAL MONITORING ❑ 4. STATISTICAL INVENTORY RECONCILIATION(SIR)+ ❑ 8. TANK TESTING BIENNIAL TANK TESTING ❑09 OTHER ��(( V.TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YRIMOIOAY) ESTIMATED QUANTITY OF SUBSTANCE REMAINING 435 TANK FILLED WITH INERT MATERIAL? gallons ❑Yes ❑No Formerly SWRCB Form 8