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U�(ED PROGRAM CONSOLIDATED FO cxi-ll�h¢iq <br /> UNDERGROUND STORAGE TANK w <br /> OPERATING PERMIT APPLICATION-TANK INFORMATION One form per Us \� <br /> TYPE OF ACTION ❑ L NEW SITE PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION 430 <br /> (Check only item only) ❑ 6.TEMPORARY SITE CLOSURE ❑ 7,PERMANENTLY CLOSED ON SITE ❑ 8.TANK REMOVED <br /> DATE UST PERMANENTLY CLOSED: 430a DATE EXISTING USE DISCOVERED: 4301, <br /> 1.FACILITY INFORMATION <br /> FACILITY ID N(Agency Use Only) FA0005704 1 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> SHINKO ELECTRIC AMERICA INC <br /> BUSINESS SITE ADDRESS 103 CITY IN <br /> 551 CARNEGIE ST I MANTECA <br /> _ n.TANK DESCRIPTION <br /> TANK IDI! 432 TANK MANUFACTURER 433 TANK CONFIGURATION:THIS TANK IS 434 <br /> © 1.A STAND-ALONE TANK <br /> TA0503158 ❑ 2.ONE IN A COMPARTMENTED UNIT <br /> DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 <br /> 564 <br /> IIL'I'AA9:CRI?,AND CONTENTS <br /> TANK USE ❑ In.MOTOR VEHICLE FUEL ❑ Ib.IWVt1NA I IJEI-ING ❑ Ic.AVIATION FUELING <br /> ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE ❑ 5.EMERGENCY GENERATOR FUEL <br /> ❑ <br /> 6.OTHER GENERATOR FUEL ❑X 95.UNKNOWN ❑ 99.OTHER(Socci&): <br /> CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ❑ In.MIDGRADE UNLEADED ❑ lb.PREMIUM UNLEADED <br /> ❑ 3.DIESEL ❑x 5.JET FUEL ❑ 6.AVIATION GAS <br /> ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): <br /> NON-PETROLEUM: ❑ 7.USED OIL ❑ 10.ETHANOL <br /> ❑ 11 OTHER NON-PETROLEUM(Socac`0 4406 <br /> IV.:TANK CONSTRUCTION <br /> TYPE OF TANK ❑ 1,SINGLE WALL ❑ 2.DOUBLE WALL ❑x 95.UNKNOWN <br /> PRIMARY CONTAINMENT ❑ 1.STEEL ❑ 3.FIBERGLASS ❑6.INTERNAL BLADDER 444 <br /> ❑7.STEEL+INTERNAL LINING ❑X 95.UNKNOWN ❑ 99.OTHER 444a <br /> SECONDARY CONTAINMENT ❑ 1.STEEL [13.FIBERGLASS ❑6.EXTERIOR MEMBRANE LINER [17.JACKETED 445 <br /> ❑98.NONE [195.UNKNOWN ❑99.OTHER(Specify) <br /> OVERFILL PREVENTION ❑ 1,AUDIBLE&VISUAL ALARMS ❑ 2 BALL FLOAT ❑ 3 FILL TUBE SHUT OFF VALVE 452 <br /> ❑4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQ(JIPMENI <br /> V.PRODUCTRVASTE PIPING CONSTRUCTION <br /> PIPING CONS IRUCI ION LJ I SINGLE-WALLED ❑ 2.DOU131 I7-WALLED ❑ 99 011 460 <br /> SYSTEM TYPE ❑ 1.PRESSURE ❑2.GRAVITY ❑ 3.CONVEN"FIONAL SUCTION ❑ 4.SAFE SUCTION 458 <br /> PRIMARY CONTAINMENT ❑ 1.STEEL ❑4.FIBERGLASS ❑ 8.FLEXIBLE ❑ HI RIGID PLASTIC 464 <br /> ❑ 90.NONE ❑95.UNKNOWN ❑ 99.OTHER 4fi4a <br /> SECONDARY CONTAINMENT ❑ 1.STEEL ❑4.FIBERGLASS ❑ 8,FLEXIBLE ❑ 10.RIGID PLASTIC 4646 <br /> ❑90.NONE ❑95.UNKNOWN ❑ 99,OTHER 464c <br /> PIPING/TURBINE CONTAINMENT SUMP TYPE ❑ 1.SINGLE-WALLED ❑ 2.DOUBLE-WALLED ❑ 99.NONE 464d <br /> VI.VENT.VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTIICTION <br /> VIeNI PIRMARY CON TAINMUN'I ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLAS'1IC ❑ 90.NONE ❑ 99.0'IHFR 464c <br /> VENT SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 464f <br /> VR PIRMARY CONTAINMENT ❑ I.STEEL ❑ 4,FIBERGLASS ❑ 12,RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 464g <br /> VR SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 4641h <br /> VENT PIPING TRANS_.SUMP TYPE ❑ I.SINGLE-WALLED ❑ 12.DOUBLE-WALLED ❑99.NONE 464' <br /> RISER PIRMARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99,OTHER 464 <br /> RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 12.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 464k <br /> FILL COMPONENTS INSTALLED ❑ 1.SPILL BUCKET ❑ 3.STRIKER PLATFBOT 0M PROTECTOR ❑ 4.CONTAINMENT SUMP 451 s-c <br /> VII.UNDER DISPENSER CONTAINMENT(UDC) <br /> CONSTRUCTION TYPE ❑ I.SINGLE--WAILED ❑ 2.DOUBLE-WALLED ❑ 3.NO DISPENSERS ❑ 90.NONE 469a <br /> CONI'RUCTION MATERIAL ❑ I.STEEL ❑ T FIBITRGLASS ❑ 10.RIGID PLAS"IIC 90.NONI; ❑ 99.O'fl IER daab-c <br /> VII CORROSION PROTECTION <br /> STEELCOMPONENIPROTECHON ❑ 2_SACRAFICIAL ANODE(S) ❑ 4.IMPRESSED CURREN I ❑ 6.ISOLAHON 4 <br /> IX.APPLICATION SIGNATURE <br /> 1 certify that this USF system is compatible with the hararduus substance stored and that the information provided herein is true,accurate,and in full <br /> compliance n'ith legal requirements. <br /> APPLICANT SIGNATURE DATE 470 <br /> APPLICANT NAME(print) 411 APPLICANT TITLE 402 <br />