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LIED PROGRAM CONSOLIDATED FOI M 01151 y� UNDERGROUND STORAGE TANK t11N 017zl1 Z OPERATING PERMIT APPLICATION - TANK INFORMATION One form per L TYPE OF ACTION [ 1.NEW SITE PERMIT [ 3.RENEWAL PERMIT ❑ 5.CHANGEIN OF FORMATION 430 (Check oNy item only) [ 6.TEMPORARY SITE CLOSURE ❑ 7.PERMANENTLY CLOSED ON SITE ❑ 8.TANK REMOVED DATE UST PERMANENTLY CLOSED: 430' DATE EXISTING UST DISCOVERED: 430b 1.FACILITY INFORMATION FACILITY ID#(Agency Use Only) FAOOO57O4 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 SHINKO ELECTRIC AMERICA INC BUSINESS SITE ADDRESS 103 CITY 104 551 CARNEGIE ST MANTECA II.TANK DESCRIPTION TANK ID# 432 TANK MANUFACTURER 433 TANK CONFIGURATION:THIS TANK IS 434 TA05O3155 C 1.ASTAND-ALONE TANK [ 2.ONE IN A COMPARTMENTED UNIT DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 564 111.TANK USE AND CONTENTS TANK USE ❑ Ia.MOTOR VEHICLE FUEL ❑ Ib_MARINA I UELING ❑ Ic.AVIATION FUELING ' ❑ 3.CHEMICAL PRODUCT STORAGE ❑ L HAZARDOUS WASTE ❑ 5.EMERGENCY GENERATOR FUEL ❑ 6.OTHER GENERATOR FUEL ❑X 95.UNKNOWN ❑ 99.017HER(So6M.. CONTENTS PETROLEUM: ❑ Ia.REGULAR UNLEADED ❑ IG.MIDGRADE UNLEADED ❑ 16.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑Q 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): NON-PETROLEUM: ❑ 7.USED OIL ❑ 10.ETHANOL ❑ I1.OTHER NON-PETROLEUM(Suecifv)'. 4401, IV.TANK CONSTRUCTION i YPE OF TANK ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑R 95.UNKNOWN 443 PRIMARY CONTAINMENT ❑ 1.STEEL ❑ 3.FIBERGLASS ❑6.INTERNAL BLADDER 444 ❑7.STEEL+INTERNAL LINING ❑x 95.UNKNOWN [ 99.OTHER 444a SECONDARY CONTAINMENT ❑ I.STEEL ❑ 3.FIBERGLASS ❑6.EXTERIOR MEMBRANE LINER ❑7.JACKETED 445 ❑98.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify) OVERFILL PREVENTION ❑ L AUDIBLE&VISUAL ALARMS ❑ 2 BALL FLOAT ❑ 3 FILL TUBE S14UT OFF VALVE 452 ❑1.'I ANK MEETS REQUIREMENTS FOR FXRMP'PION FROM OVERFILL PREVENTION EQUIPMENT V.PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUC II ON U I_SINGLE-WALLED ❑ 2,DOUBI I.-WALLED ❑ 92 OTHER" 460 SYSTEM TYPE ❑ 1.PRESSURE ❑2.GRAVILY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 458 PRIMARY CONTAINMENT ❑ L STEEL ❑4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑90.NONE ❑95.UNKNOWN ❑ 99.OTHER 464, SECONDARY CONTAINMENT ❑ L STEEL ❑4.FIBERGLASS ❑ 8.FLEXIBLE ❑ I0.RIGID PLASTIC 464b ❑ 90.NONE ❑95.UNKNOWN ❑ 99.OTHER 46'1° PIPING/TURBINE CONTAINMENT SUMP TYPE ❑ I_SINGLE-WALLED ❑ 2.D011131.1-WALLET) ❑ 99 NONE 464d VI.VENT.VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTUCTION VENI-PIRMARYCONTAINMENI ❑ I.SIEEL ❑ 4.PIBERGI.ASS ❑ IO.RIGIDPLASIIC ❑ 90 NONE ❑ 99.011]LIZ 464e VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASI IC ❑ 90.NONE ❑ 99.OTHER 464f VR PIRMARY CONTAR04ENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 4648 VR SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 464h VENT PIPING TRANS...SUMP TYPE ❑ 1.SINGLE-WALLED ❑ 12.DOUBLE-WALLED ❑99.NONE 464i RISER PIRMARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 4641 RISER SECONDARY CONTAINMENT ❑ I.STEEL, ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99,OTHER 4641, FILL COMPONENTS INSTALLED ❑ 1.SPILL BUCKL I' ❑ I STRIKER PLA'117BOI"1'OM PROTECTOR ❑ 4.CONTAINMENT SUMP 451a-c R'I,., VII.UNDER DISPENSER CONTAINMENT(UDC) CONSIRUC I'[ON TYPE ❑ L SINGLC-WALLED ❑ 2.DOU13LL-WALLED ❑ 3.NO DISPENSERS [190 NONE 4611a CONTRUCTION MATERIAL ❑ I.SJLLL ❑ 4FIBFRGLASS ❑ IO.RIGIDPLASIIC 90.NONE ❑ 99.OTHER 4691-e. VIII.CORROSION PROTECTION SI EF LCOMPONFNT PROTLCHON ❑ 2_SACRAFICIALANODE(5) ❑ J_IMPRFSSFDCURRLNT ❑ 6.I.SOLA I ION 48 IX.APPLICATION SIGNATURE 1 certify that this US'I system is compatible with the hazardous substance stored and that the information provided herein is true,accurate,and in full compliance with legal requirements. APPLICANT SIGNATURE DATE 470 APPLICANT NAME(print) 411 APPLICANT TITLE 472