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Home My WebLink AboutUNDERGROUND TANK 6/15/1991 COMPLETE AUTOMOTIVE SERVICE~ ? 1 Block East of Chester ,~' Bakersfield, CA 93304 ~ ~ 327-7277 ,ws,o. ~bC/ 21~30~G Street, Bakersfield, CA 93301 ~G~UND TANK QUESTIONNAIRE i FACILI~/S NO OF NKS ~ . . . . HAZ. MAT. DIV. ~80XTOINDICATE ~COR~RAIION :~NDIVIDUA[ ~PAR~ER~HIP ~L~ALAGENCYDIS~IC~ ~COUN~AGENCY ~STATEAGENCY ~FEDE~LAGENCY ~PE OF SUSlNE~ ~ ] GAS STATION ~ 2 DISTRIBUTOR ~ KEEN COUN~ PERMtT ~ 3 FA RM ~ 4 PROCE~OR ~50~HER TO OPE~ ~. .EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) optional DAYS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE , DAYS: NAME (LAST. FIRSt} PHONE No. WITH AREA CODE NIGHTS: NAME (~ST, FI~ PHONE ~. Wl~ AR~ CODE NIGHTS: NAME (~ST, FI~ PHONE ~. WI~ AR~ CODE MAILING OR STRE~ ADDRESS ~ BOX ~INDIVIDUAL ~ LOCAL AGENCY ~ STAI~ AGENCY III. TANKOWNER INFORMATION (MUST BE COMPLETED) MA(LING OR STREET ADDRESS ~ ~OX ~IVlDUAL ~ LOCAL AGENCY Q STATE AGENCY CI~ NAME STATE ZIP CODE , ~ PHONE No. WITH AR~ CODE OWNER'S DATE VOLUME PRODUCT IN ! TANK No. INSTALLED STORED SERVICE YIN YIN Y/N 'YiN YIN DO YOU HAVE FINANCIAL RESPONSIBILITY? Y(0TYPE 7~.,~. Fill one segment olfor each tank, unless all s and piping are ~ -~ ~ constructed of the~same materials, style and , then only fill one segment out. please identify tanks by owner ID #. I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN III. TANK CONSTRUCTION MARK ONE ImM ONLY IN BOXES A, B, ANDC,~DALLTHATAPPLIESINBOXD A. ~PE OF ~ ~ DOUBLE WALL ~ 3 SINGLE WA~ WI~ E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL ~ 4' SECONDARY CONTAINMENT'(VAUL~D TAN~ ~ 99 O~ER B. TANK ~ 1 8ARESTEEL ~ 2 STAINLESS STEEL ~ 3 FIBERG~SS ~ 4 STEELC~DW/FIBERGLA~REINFORCEDP~STIC MATERIAL ~ 5 CONCRE~ ~ S POLWINYL CHLORIDE ~ 7 ~UMINUM ~ 8 1~ ME~ANOL ~MPATIBLEW~RP ~ 1 RUBBER LINED ~ 2 ~0 LINING ~ G EPO~ LINING ~ 4 PHENOL~ LINING C. INTERIOR Um.G ~ s a~ UN~Na ~ S UNUN~ ~ ~ UN~OWN ~ IS LINING N~TEmAL ~PATIBLE WITH 1~ ~E~ANOL ? YES ~ NO~ D. OORROSION ~ ~ ~LYE~YLENE WRAP ~ 2 ~AT~Ne "~ 3 VI~L WR~ . ~ ~ ~InEnGL~S nEINFOnCEO P~ST~C PROTEC~ON ~ s CATHODIC ~nOTECT~aN ~ .~ NON~ .~.~ UN~OWN , ~ m omen IV. PIPING INFORMATION c~Rc~ A IF ABOVE GROUND OR U IF UNDERGROUND, BOm IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVI~ a. CONSTRUCTION A U 1 SINGLE WALL A U 2 ~UBLE WALL A U 3 LINED TRENCH A ~N~ A U ~ O~ER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS S~EL A U 3 ~L~iNYL CHLORIDE (PVC)A U 4 FIBERG~S PIPE CORROSION A U 5 ~UMINUM A U 6 CONCRE~ A U 7 ST~ A U 8 1~ ME~ANOL ~MPATIBLEW~RP PROTECTION A U 9 ~LVANIZED S~EL A U 10 CATHODIC PROTECTIONA~5 UN~ A U ~ O~ER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DE~CTOR ~ 2 LINE T~HTNESS TESTING ~ 3 [NT~S~L V..TANK LEAK DETECTION I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D, # B, MANUFACTURED BY: C. DATE INSTALLED (MO/DAY/YEAR) D, TANK CAPACITY IN GALLONS: III. TANK- CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESIN8OXD A.'TYPEOF [] I DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] I BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAo W/FIBERGLASS REINFORCED PLASTIC~ MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] .8 100% METHANOL COMPATIBLEW/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] ~ RUBBER L,.ED [] ~ ALkyD L,N~.G [] ~ E.OX~ L,.,NG [] ~ PHE.OL~ L,.,.G C. INTERIOR [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN ~] g9 OTHER IV. PIPING INFORMATION ' CIRCLE -A iFAI~OV~(~-R~UND-OR-U IF UNDERGRbUN-D,~OTHIFAPPLICABLE A. SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U g9 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE (PVC)A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE T~GHTNESS TESTING [] 3 iNTERSTITIAl. MONITORING [] 99 OTHER V. TANK LEAK DETECTION ~,~ v,SUAL OHECK [] ~ ,.VENTORY RECONC,L,AT'ON E~ VAPO. MO.,TOR,NG[~E]'~ AUTO~AT,CTANKGAUG,NG [] ~ GROUNO WA'~RMO"'TOR~G !-_.-] ~ ~A.~ ~ES~mNG F--1 . ,.TERS~ITI~LMO.,~OR'NG ELI "' NO.E [] .~ ..KNOW. ED ~" OTHER '1_..'I'A~K DESCRIPTION COMPLETE ALL SPECIFY IF UNKNOWN A. OWNER'S TANK I. O. # I S. MANUFACTURED C. DATE INSTALLED (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN SOXES A. O. ANO C, AND ALL THAT APPLIES IN BOX D A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EX'rERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTEDTANIO [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEELCLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (PrimaryTank) [] 0 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER ~ , RuBB~. LINED [] 2 AL~'D LIN,NG[] 3 EPOXY LINING []., PHENOLIC LI"ING C. INTERIOR UNING [~ 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES_ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION, [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RC~ & IFABOVEGROUNDOR U IFUNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U I SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U i SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U I BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE(pvC)A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A [J 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [~] I AUTOMATIC LINE LEAK OETECTOR [] 2 LINE TIGHTNESS TESTING [] 3MONITORINGINTERSI')TI~L [] 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING [] 6 TANK TESTING [] 7 INTERSTITIAL MONITORING [] B1 NONE [] ~)S UNKNOWN [] ~9 OTHER I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I.D.# B. MANUFACTURED BY: C: DATE INSTALLED (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINBOXD A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK} [] 99 OTHER B. TANK ~ 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] s POLWlNYL CHLORIDE [] 7 ALUMINUM [] e l~/o METHANOL COMPAT~BLEW/FRP (Primarymank) [~ 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] 1 RUBBER LINED [] 2 ~.KYD LINING [] 3 EPOXY UNmNG [] 4 PHENOLIC UNmNG C. INTERIOR [] 5 GLASS LINING [] B UNLINED [] 95 UNKNOWN [] gg OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~.CL~ A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A U 2 PRESSURE 'A U 3 GRAVITY A U 99 OTHER B. CONST~UCTJO-N A tJ ~ SU~LE W~-LL ' ]k U- 2 -D~)UBLE WALL' ' - ~-U -3 LINED-TRENCH' A U 95 0--NKNOWN A U 9g OTHER C, MATERIAL AND A U 1 8ARE STEEL A U 2 STAINLESS STEEL A U 3 POLYWNYL CHLOR)DE(PVC)A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 10(7'/o METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D, LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 I~TERSTITIAL · MONFFORJNG [] 9g OTHER V, TANK LEAK DETECTION I [], VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIOTANKGAUGING[~ 5 GROUNDWATERMONITORINGI [] ~ TANK TESTING [] 7 tNTERSTITIALMONmTORING [] B1 NONE [] BS UNKNOWN [] ~ OTHER