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,,eee,,0UD PROGRAM CONSOLIDATED FCS UNDERGROUND STORAGE TANKS- TANK PAGE 1 TANKS (two pages per tank) TYPE OF ACTION ❑1 NEW 517E PERMIT ❑ 4 AMENDED PERMIT [15 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE Pg 3 of s (Chale orre Dem only) ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT (SP fyrmsm-forkcelwemly) (Sp wymwm-t balux oNy) X BTANK REMOVED 430 BUSINESS NAME(S..FACILITY NAME w DRA-Doing BmmssAe) 3 FACILITY ID: O O O O O O O O O O O 1 Chevron Station#90557 LOCATION WITIHN SITE(opeeeeo) 139 S Cerner SL,Stockton,CA 95202 431 1.TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANKID# 432 TANK MANUFACTURER 433 COWTaLTMENTALIZEDTANK ❑Yes S No 434 38099 JOOR R•vw wopkmanepase ores h omparonmt DATE INSTALLED(YEAR/MO) -3 1 TANK CAPACITY IN GALLONS436 NUMBER OF COMPARTMENTS 437 1/1/90 10,0(10 0 ADDITIONAL DESCRIPTION(Fm meal nee may) 438 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE ®L MOTOR VEHICLE FUEL ❑la REGULAR UNLEADED ❑2. LEADED4ao ❑5. JET FUEL (Ifmakdeompbte Petroleum Type) [I lb. PREMIUM UNLEADED ❑3. DIESEL ❑6. AVIATION FUEL ❑2. NON-FUEL PETROLEUM 10 Ic. MIDGRADE UNLEADED [14. GASOHOL [199 OTHER ❑3. CHEMICAL PRODUCE COMMON NAME (from H..*.Melaiels lr wy page)) MI CAS#(frau He.&..Matmel.lev oy P ) 442 04. HAZARDOUS WASTE ne b Used 0i0 ❑95 UNKNOWN MID-GRADE UNLEADED 800-61-9 III. TANK CONSTRUCTION TYPE OF TANK 0 1. SINGLE WALL 3. SINGLE WALL WITH 0 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Checkmeitanmly) EXTERIOR MEMBRANE LINER ❑95. UNKNOWN S 2. DOUBLE WALL [14. SINGLE WALL IN VAULT ❑99. OTHER TANK MATERIAL-prmay amk I. BARE STEEL 0 3. FIBERGLASS/PLASTTC 5. CONCRETE 095. UNKNOWN 444 (Check one imn.1y) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/1001/e METHANOL ❑99.OTHER_ REINFORCED PLASTIC(FRP) TANK MATERIAL-se mery amk 1. BARE STEEL 0 3. FIBERGLASS/PLASTIC 5. CONCRETE U 95. UNKNOWN 445 (Checkonertm Dory) ❑2. STAINLESS STEEL S4. STEEL CLAD W/FIBERGLASS 08. FRPCOMPATIBLEW/1001%METHANOL ❑99.GEHER_ REINFORCED PLASTIC(FRP) ❑10.COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING 0 1.RUBBER LINED 3.EPDXY LIMNG 5.GLASS LINA)G 95.UNKNOWN 446 DATE INSTALLED 447 OR COALING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99 OTHER (Chckms4unaJy) (Forlmalucemly) OTHER CORROSION ❑1 MANUFACTURED CATHODIC S 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 4� 448 PROTECTION IF APPLICABLE PROTECTION ❑41MPRESSED CURRENT ❑99 OTHER (Chock one 6m only) ❑2 SACRIFICIAL ANODE (Forbwluu mly) SPILL AND OVERFILL YEARINSTALLED 4% TYPE(bcel we only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all 0w apply) 10 OP FILL TUBE SHUT OFF VALVE S 1 SPILL CONTAINMENT 1990 _ ®1 ALARM OPW 61-SO-4 S 2 DROP TUBE 1998 OPW 61-SO-4 ❑2 BALL FLOAT ❑4 EXEMPT S 3 STRIKER PLATE Tank Mfg _ IV.TANK LEAK DETECTION(Ad-Wtbn oftt emmmosprogamandl besubmdldmae:bwl asmf IF SINGLE WALL TANK(Cheekautbmepply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING MTG (Check one nem wily) ( ) ❑I VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE S 2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4STATISTICAL INVENTORY RECONCILIATION ❑STANK TESTING (SIR) BIENNIAL TANK TESTING ❑99 OTHER _ IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 956 TANK FILLED WITH INERT MATERIAL? 457 12/3102 Unknown at this time gallons X Yea ❑ No Will Be