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r 05a0fz1 �V lid
<br /> UNIFIED PROGRAM CONSOLIDATED FORM 1'
<br /> UNDERGROUND STORAGE TANK h 1 1 �
<br /> OPERATING PERMIT APPLICATION-TANK INFORM L ION (One term j er US[I
<br /> TYPE OF ACTION (Check one item only. For an LIST permanent closure or removal,complete only this section and Sections[,B,III,IXd t(jeI&JI1 1 4311
<br /> ❑ I.NEWPFRNII-1" ® 3.RENEWAL PERMIT ❑ S,CHANGE OF INFORMATION
<br /> ❑ 6.TEMPORARY"I.IS ICLOSURE X7,US I PERMANENT CLOSURE ON SITE ❑ S.UST REMOVAL
<br /> DATE LIS I'PERMANENTLY CLOSED: 4101 DATE EXISTING UST DISCOVER= -ALTH
<br /> L
<br /> FACILITY INFORMATION _
<br /> FACI L ITY I D 9 1-lgen,j Use Onh) IF F II
<br /> BUSINESS NAMF(Same as FACILITY NAME or DBA-Doli :.i.c. A,1
<br /> Miles Trust Property
<br /> BUSINESS SITE ADDRESS C'HY 04
<br /> 1940 South American Street Stockton,CA 91206
<br /> 11.TANK DESCRIPTION
<br /> TANKID9 4%- I.A`,K M:vNI I'.A( I IIRFR 4i4 I ANK('ONFIGIIRv I tv- 1111, 1vvKIc 414
<br /> Unknown © (..%STAND-vLONE 1:4Nk
<br /> ❑2.ONE INA CUM PV4TN IF NED UNN
<br /> Cam fete one page for each eon,anmmnt m Ih<.na
<br /> DATE UST SYSTEM INSTALLED 441 "LANK CAPACITY INBER OF COMPARTMENTS IN THE UNIT 417
<br /> Unknown 250-500 GALLONS "^ NUMONE
<br /> III.TANK USE AND CONTENTS
<br /> TANK USE Ia.MOTOR 9 EHICLE FUELING ❑ IF NLARIN:A I'(I;L LNG ❑ 11 AVIATION FUELING 41°
<br /> ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 1.11 VARDOCS tiASl iudes Used Oip ❑ S EMERUFNC Y GENERATOR -1+1 piSr;151e19a1
<br /> ❑ 6.01 HER GENERATOR FC EI. ❑ 95.UNKNOWN' ❑ 91) OTHER (Specify): 4(911
<br /> CONTENTS PETROLLLNI M'Ia"Ri G(;I..AR UNI.FADED ❑ Io.MIDGRADE UNLEADED ❑ It, PREMIUMUNLEADEp 446
<br /> EN3.DIESEL ❑ 1.11=frit❑( ❑ 6.AA'AI ON GAS
<br /> El S.PT'ROLEI Al BLEND I'I'F-1_ ❑ 9.01111 R PITROI.FUM (S e6tfi 4411.
<br /> NON-PETROLEtAl El 7 1 SIDn11 ❑ Ie.1 THAN01.
<br /> ❑
<br /> 11 GIB[ vI rRU1I' _ wllb). 441F
<br /> 1A �FANKCONSTRUCTION
<br /> 9YPEOr TANK ® 1 1 ❑ 9s UNKNOWN 441
<br /> PRIM\R1'CONTAINNIE\'I ❑ I T ❑ ❑ t I\-I'L'R\AL BLADDER 444
<br /> ❑ 7., _ _... ❑ o. ONKNORN ❑ 91) WHILE (Speed'v l'. 444.,
<br /> SECONDARY (ONTAINNIEN'T ❑ I ,. ❑ I Ass ❑ , I\11 SIGN MI NIBR,ANF 1.1A1 R ❑ 7 4 WKETf D 445
<br /> ❑ „,, ❑ •.,n\N ❑9, or F:R($,cal R_1 441,1
<br /> OVFRFH.I PRFVEVI ION ❑ 1 ❑ ' BALL FIG("4 ❑ 1 IT 1.11 BF CI4C'144T% MAT 412
<br /> ❑ [OR GAI.NI PIIUA ht Olt OA'EIt FILL 1'REV P.NIION 13)111'%1[AT
<br /> V. PROM CI'/WASTE PIPING CONSTRUCTION
<br /> PIPING COy> ,A ISPUI I-AN dI I CD ❑? DOUBLE-R"ALLL1) ❑110.01 ILR 4aI
<br /> SYS FEN[II I' ❑ 11'121 -1 I?1 ❑ 2.GRAVITY ❑ 7 CONV'ENTIONALSUCTIOAI ❑ 1 SAFE SLICfIONI23CCRC263O(el(:)I 453
<br /> PRINIV:' 'I<I ® I_< '. El.FIBERGLASS ❑ S.FLEXIBLE ❑ In.RIGID PI.A.S'fIC 464
<br /> __. _ ❑ uu ❑ 95_I-NKNO ,N ❑ 99.OI'HERISpenlyl: 464,1
<br /> `I' ❑ ❑
<br /> 1-11111 EGL;ASS ❑ € FI CXIBLF
<br /> ❑ 10.RIGID PLASTIC 4646
<br /> _ I.7 ❑ 9s.1 \KwN\\ ❑ ,y Orn I[R(�,. Ir 4e4,-
<br /> I'_t- I cVl' IO LLSINGLE H ALL ❑ 2.DOIkiIAAM1 1)0,NONE 4,µd
<br /> _ VI. VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION
<br /> Vk:NT PRI,4l n U yA4FA I' L STEEL 4.FIIn RGI ASS ❑ 10.RIGID PI AS"I'IC ❑ 00 NOMI ❑ "9 OTHER(SN,,i O 4641
<br /> 4,411
<br /> VFATSI.(,)ADAG', N ';MLV'I S'IIJ I ❑ 4.FIBERGLASS ❑ Io_RRADPLASITC © "0 NON('' ❑ 99.OTHER(Specn`,) 4a4f
<br /> 6441
<br /> VR 1'RIMAIi1 (JAI AI viPV ❑ I SFEEI_ ❑ 4.FIBERGLASS
<br /> ❑ in RIGID PLASTIC ® 90_NONE ❑ )P"OTHER(Speciryl 4641
<br /> 4",1
<br /> VR SECONR.ARY CONT AINVI I'NT ❑ I.51 EFL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC E3 90.NONE ❑ 99,OTHER ISpecifyq 1G4h
<br /> 6441
<br /> I \\SIIIUN SONIP T YPE ❑ I.SINGLE WALL ❑ S.DOUBLE N'.4LL E3 90.NONE 4641.
<br /> N'1 tea I.NI WII VI ❑ I.STEEL ❑ 4.FIBF.RGI-ASS ❑ In"RIGID PLASTIC EN In NONE ❑ 91) OTHER(Specify) 4641
<br /> _....._..__ 464 I
<br /> li),Ill'. - �. - VI ANIIN'T ❑ I_STEEL ❑ 4.FIBERGLASS ❑ ICI.RIGID PLASTIC © 9U.NONE ❑ 99,OI'LIFR(Spe fi) 464k
<br /> 464k1
<br /> FII( Cu l+ U.I IID ❑ I_SELLI.BUCKET ❑ 3.STRIKER Ill_ATE IBO'F]ONI PROTECTOR ❑ 4.CONIAINibIENTSIAIP 411.-c
<br /> VII.UNDER DISPENSER CONTAINMENT(UDC)
<br /> CONSTRUCTION"I'YPh: ❑ I.SIINGI.E W ALL ❑ o_.DOUBLE WALL EXI.NO DISPENSERS El 911"NONE 46%
<br /> CONSTRUCTIOS SIAI'ERIAL ❑ I.STEEL ❑ 4.FIBF.RGI.ASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER S,0,) 4691rc
<br /> VIII. CORROSION PROTECTION
<br /> SI'I I Cl lA4POAL.NI PROTECTION ❑ 3.SACRIFICIAL ANODIAS) ❑ 4.IMPRESSEDCURRENT ❑ 6.ISOLATION 448
<br /> IX. APPLICANT SIGNATURE
<br /> CER"IIFIC\"FIOX: 1 certify that this OST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate,
<br /> and in full Com Bance with legal requirements.
<br /> APL NT 'IG 1 DATE n°.
<br /> A LI TNAME(print) 411 APPLICANT TITLE47z.
<br /> Reba Veltri Trustee
<br /> UPCF UST-B-I/2 Rev.(12/2007)
<br />
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