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UST Program: Tank Information Permit Application: CERS Business Page 1 of 2 <br /> California Environmental Reporting System:Business Randy Laney's Account Sign Ou Tools Reports HeID <br /> 1lMe 5110111k�t ►ii#IUas OOaIMINartos IIr�IMIMaa <br /> UST Tank Infornnation/Monitoring Plan: LODI MUNI SERVICE CENTER <br /> Home D Submittal History D Submittal.10/9/2018(10181549) N UST.UST Tank Information/Monitoring Plan(Submitted) <br /> ib <br /> Use this form to enter data for new UST systems or revise data for an existing UST system.You must complete a separate form for each affected tank.For tanks that are part of a <br /> compartmentalized unit,each compartment is considered a separate tank.This information is required within 30 days of permit or facility information changes,unless your local <br /> agency requires approval prior to making the changes. <br /> Select Edit to modify/add your UST tank/system information. <br /> The former paper version of this form was called"UST Operating Permit Application-Tank Information"(Form B). <br /> Submittal Element History <br /> Submitted for CERS ID 10181649 on 10/9/2018 9:05AM by Randy Lane of LODI MUNI SERVICE CENTER(LODI CA) <br /> wMa"ftimem alit fto"a" <br /> C4 REk" RVED <br /> Type of Action— <br /> Type of Action(UST Tank) <br /> Confirmed/Updated Information <br /> acilky Information <br /> LODI MUNI SERVICE CENTER DEPARTMENT1331 S HAM Ln <br /> LODI , CA 95240 <br /> Tank Description <br /> Tank ID# Date UST System Installed Tank Configuration <br /> TA0133208 1/1/1989 A Stand-alone Tank <br /> Tank Manufacturer Date Existing UST Discovered Number of Compartments in the Unit <br /> PERKINS 1 <br /> Tank Capacity In Gallons Date UST Permanently Closed Additional Description <br /> 2000 <br /> Tank Use and Conten Tank Construction <br /> Tank Use Tank Contents Type of Tank <br /> Motor Vehicle Fueling Regular Unleaded Double Wall <br /> Other Petroleum Contents <br /> Primary Containment Secondary Containment <br /> Other Non-Petroleum Contents Steel Steel <br /> Overfill Protection <br /> Yes Audible(Visual Alarms No FIII Tube Shut-Off Valve <br /> No Ball Float No Exempt <br /> —Product/Waste Piping Construction <br /> Piping Construction Primary Containment I Secondary Containment I Piping/Turbine Containment Sump <br /> Double-walled Fiberglass Fiberglass Single-walled <br /> Piping System Type <br /> Pressure <br /> Vent,Vapor Recovery(VR)and Riser/Fill Pipe Piping Construction <br /> Vent Primary Containment Vapor Recovery Primary Containment Riser Pipe Primary Containment Vent Piping Transition Sumps <br /> Fiberglass Fiberglass Steel None <br /> FIII Components Installed <br /> Vent Secondary Containment Vapor Recovery Secondary Containment Riser Pipe Secondary Containment Yes Spill Bucket <br /> Fiberglass None None <br /> _ Yes Stoker Plate/Bottom Protector <br /> No Containment Sump <br /> Under Dispenser Containment(UDC) —Corrosion Protection <br /> Construction Type Construction Material Yes Sacrificial Anode <br /> Single-walled Fiberglass No Impressed Current <br /> No Isolation <br /> Created By:Randy Laney on 10/9/2018 8:35 AM <br /> Last Updated By:Randy Laney on 10/9/2018 9:01 AM <br /> L11 I".CERS Help Settings My Business <br /> - -- -- <br /> https://cersbusiness2.calepa.ca.gov/49865/Facility/10181549/Submittal/UST/3143840/Ta... 10/10/2018 <br />