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L,JHD PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANKS- TANK PAGE 1 TANKS (two pages per tank) TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE Page 5 of 8 (Check one man only) ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT (Spmify noon-for kcal lore only) (Specify recon-for lord loo only) X 8 TANK REMOVED 430 BUSINESS NAME(Same a FACILITY NAME or DBA-Doing Business la) 3 FACILITY ID: 0 0 0 0 0 0 0 0 0 0 0 I Chevron Station#90557 p LOCATION WITHIN SITE(optkme0 139 S Center St,Stockton,CA 95202 431 L TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANKED X 60 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK Yes D9 No 434 lft:L7' JOOR If-Y.",coopkm one poli¢fc,each coopmanmt DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1/1/90 1 10,000 0 ADDITIONAL DESCRIPTION Be,local use only) 438 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE ® I. MOTOR VEHICLE FUEL ❑In. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL Ofineekd compleee Paroi..Type) ®Ib. PREMIUM UNLEADED ❑3. DIESEL ❑6. AVIATION FUEL ❑2. NON-FUEL PETROLEUM ❑lc. MmGRADE UNLEADED [14. GASOHOL Cl 99.OTHER 03. CHEMICAL PRODUCT COMMON NAME (fran Hemdoua Memriel.tmmbry peg) 441 CASS(from Haeerdons mnmeb 1.,amm page) 442 E3 4. HAZARDOUS WASTE (Includes uaaOil) PREMIUM UNLEADED 800-61-9 ❑95.UNKNOWN HL TANK CONSTRUCTION TYPE OF TANK 1. SINGLE WALL 3. SINGLE WALL WITH 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (ChmkamimmoNy) EXTERIOR MEMBRANE LATER 095. UNKNOWN ®2. DOUBLE WALL ❑4. SINGLE WALL IN VAULT [199 OTHER TANK MATERIAL-promy tank DOI. BARE STEEL 01 FIBERGLASS/PLASTIC 5. CONCRETE L3 95. UNKNOWN 444 (Chale one aan only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑S. ERP COMPATIBLE W/100%METHANOL ❑99.OTHER_ REINFORCED PLASTIC(FRP) TANK MATERIAL-semndmY look 1. BARE STEEL 0 3. FIBERGLASS/PLASTIC 5. CONCRETE L1 95. UNKNOWN 445 (Chmkoro can mly) ❑2. STAINLESS STEEL ®4. STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE W/100%METHANOL ❑99.OTHER_ REINFORCED PLASTIC(FRP) ❑10.COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING Lj 1.RUBBER LINED 0 3.EPDXY LINING 5.GLASS LINING 0 95.UNKNOWN 446 DATE INSTALLED 07 ORCOATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING N 6 UNLINED ❑99 OTHER (Chookom hc.only) (For local uae only) OTHER CORROSION 01 MANUFACTURED CATHODIC 193 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 aas PROTECTION IF APPLICABLE PROrECDON ❑4 ATPRESSED CURRENT ❑99 OTHER (Chock...don only) ❑2 SACRIFICIAL ANODE (Forloulueeonly) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local...ly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chookall thin Wly) ®3 FILL TUBE SHUT OFF VALVE ®I seal CONTAINMENT 1990 N I ALARM OPW 61-SO-4 ®2 DROP TUBE 1998 OPW 61-SO-4 ❑2 BALL FLOAT_ ❑4 EXEMPT ®3 STRIKER PLATE Tank Mf IV.TANK LEAK DETECTION(A denaiption ofthe monimring pm®ma andl he..named roam local agmey.) IF SINGLE WALL TANK(Chock dl aha appy) 453 IF DOUBLE WALL TANK OR TANK WITH BL ADDER 454 ❑ (Chock one can any) I VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING (MIG) ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE 19 2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑STANK TESTING (SIR) BIENNIAL TANK TESTING ❑99 OTHER W.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/M(YDAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 451 12/31/02 Unknown at this time gallons x Yes ❑ No Will Be � hr.�