COMPLIANCE INFO_1997-2003 - Laserfiche WebLink

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. IFIED PROGRAM CONSOLIDATED FO p1 ` 4 4 ` ! � IA NKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 ` >`� 1 (two pages per tank) .`Page-of TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION n❑ 6 TEMPORARY SITE CLOSUf�E 6 (Check one item only) " `7�'PtRMA NTLY CLOS D N SITE X,":.. A 3 RENEWAL PERMIT (Specify reason-for local use only) (Specify reason-for local use only) 8 TANK RI=1�IOVj Q 430 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) FACILITY ID: 7-Eleven#32262 3 I`C A-F'6 0 �1 1-71-7 3 LOCATION WITHIN SITE(Optional) 7/Z a�31 2360 Grant Line Rd., Tracy, CA ES�1PT ( palest 1Ar1t1 rat100 of�#� well" tng bl�itdtngs and t�ItidlYlarks shalt.be,submitted to a Jot sl w, �� r ¢') '' TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ® No 434 3 A p-5 D -7 Bakersfield If"Yes",complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 7/1998 10,000 ADDITIONAL DESCRIPTION(For local use only) 436 y !I.'I`;4N £INTENT •,; 77 . �...- TANK USE 439 PETROLEUM TYPE 440 ®1. MOTOR VEHICLE FUEL ❑1a. REGULAR UNLEADED [:12. LEADED [15. JET FUEL (If marked complete Petroleum Type) ®1 b. PREMIUM UNLEADED [13. DIESEL ❑6. AVIATION FUEL [12. NON-FUEL PETROLEUM ❑1c. MIDGRADE UNLEADED ❑4. GASOHOL [199.OTHER [:13. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) 442 [14. HAZARDOUS WASTE Gasoline (Includes Used Oil) ❑95.UNKNOWN ,v3 \ lllt TANK Cp1P7UCTICIN TYPE OF TANK 1. SINGLE WALL [13.SINGLE WALL WITH ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [195. UNKNOWN 2. DOUBLE WALL ❑4. SIGNLE WALL IN VAULT [199. OTHER TANK MATERIAL-primary tank [:] 1. BARE STEEL [13. FIBERGLASS/PLASTIC [15. CONCRETE [195. UNKNOWN 444 (Check one item only) [:12. STAINLESS STEEL [14. STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE W/ 99.OTHER -n / REINFORCED PLASTIC(FRP) 100%METHANOL ,Ae-11 -W TANK MATERIAL-secondary tank ❑1. BARE STEEL [13. FIBERGLASS/PLASTIC ❑5. CONCRETE ❑95. UNKNOWN 445 (Check one item only) ❑2. STAINLESS STEEL [14.STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE ❑99.OTHER REINFORCED PLASTIC(FRP) W/100%METHANOL [15. CONCRETE [110.COATED STEEL TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING [15.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ❑6 UNLINED [:199 OTHER (Check one item only) (For local use only) OTHER CORROSION ❑1 MANUFACTURED CATHODIC❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 446 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION [-14 IMPRESSED CURRENT ❑99 OTHER (Check one item only) ❑2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all ®1 SPILL CONTAINMENT that apply) 1998 1 ALARM ®3 FILL TUBE SHUT OFF VALVE ®2 DROP TUBE 1998 ❑2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE 1998 IuTANKt*EAKpETEGTIQ Rs `';pdtsp' temranitor7Cf9,•prwrgrerii'sraiiiesubmittedto-the local agency.} IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) ❑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 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER sAll ! � Ct,45t31INFQI�i1AAQ EIS COSUf3t1�PL�HC�:'' ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE 456 TANK FILLED WITH INERT MATERIAL? / 457 REMAINING gallons []Yes ❑ No UPCF (1/99 revised) 0 Formerly SWRCB Form B