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Container Construction <br /> E. O of Rubber Lined O 02 Alkyd Lining ❑03 Epoxy Lining O o. Phenolic Lining ❑os Glass Lining O ob Clay Lining ` <br /> I <br /> Ito, Unlined O oe Unknown Cog Other <br /> F. O of Polyethlene Wrap O o2 Vinyl Wrapping ❑03 Cathodic Protection I <br /> O o+ Unknown O oe None O oe tar or asphalt O o0 other. Fiberglass Reinforced <br /> Plastic <br /> VI Piping <br /> A. Aboveground Piping: O of Double-walled pipe ❑ o2 Concrete-lined trench ❑ oe Gravity O oA Pressure ❑oe Suction i <br /> [(Check) appropriate box(es)] Cl oo Unknown ❑ 07 None <br /> B Underground Piping: Mi Double-walled pipe ❑o2 Concrete-lined trench O oa Gravity J§oa Pressure ❑ oo Suction <br /> [(Check) appropriate box(es)] ❑oa Unknown Cl 07 None <br /> VII Leak Detection <br /> O or Visual 0 o2 Stock Inventory O 03 Tile Drain O o.Vapor Sniff Wells ❑os Sensor Instrument <br /> O oe Ground Water Monitoring Wells ❑o, Pressure Test ❑oe Internal inspection ❑og None <br /> oto Other Continuous electronic monitoring <br /> VIII Chemical Composition of Materials Currently or Previously Stored In Underground Containers <br /> If you checked yes to IV-F you a•e not required to complete this section. <br /> =01+01211 Pndousy chemical Do Not Use eomme•uai Name (use aaonwnai paper to,more room <br /> store0 storeo CAS a pt kn0.+/nt <br /> 001 ❑02 <br /> 001 ❑02 <br /> ❑O1 ❑02 <br /> Is Container located on an Agricultural Farm? O of Yes b o2 No <br /> P n Fil'ng(Si gnatPnone-/wcacoce <br /> For Local Agency Use Only <br /> AGENCY NAME CI Tr COUNTY <br /> CONTACT PERSON PHONE w/AREA CODE j <br /> INSPECTION DATE OST INSPECTIONI PERMIT APPROVAL DATE PE14M14 ID. NUMBER i <br /> F <br /> FOR STATE USE ONLY <br /> 8 4 A 4 E 1 D. N VM B E R AC cpuntrn9 Number County Number <br /> Date Recmveo O of O 0. O o] <br /> Majors Engineering, Inc. , 100 Park Plc. , #220, San Ramon, Ca. 94583 <br /> 415-820-2423 <br /> ,I <br />