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<br /> I:N'IFIE D PROGRAM CONSOi.1DATED POR!VI
<br /> UNDERGROUND STORAGETANK
<br /> OPERATING PERMIT APPLICATION-TANK INPORIvv�N1' n c::_IOI,, nr I_I
<br /> I YPE OF ACTION IChcck one itcortn ly, Far i>'1'pemtanent closure or removal.emnplew nnl)this Section;Ind Sections l II 1\ J'..":I
<br /> ❑ L NEW PERNII'1' Can l121:Nl WA I.PERMIT ❑ i.CL6\NCt OF FIT q::bl,\'1 0'
<br /> 6.TISMI''OI(ARl'USI'CLOSURE • X7.Lis'I'I'GI(AI:\NEN'I'C'LOSIiHr--.ON SII IS ❑ S.UST REMOVAL
<br /> DATE L.':S1'PE:Ic4B\..\LIN"FI-I"CLOSEDD.•\11:HXIS-1 ING US I DISCOVEREDr
<br /> 1. FACILITY INFORMATION
<br /> PACII-11W ID N I:Icrn.�r Il:m O,do 1
<br /> BUSINESS NANII::(Came as PACI1YrY N:\\Ifi nr DRA-DOin_e 111I.S1ncsS As)
<br /> Miles'fntst limperry
<br /> BUSINESS 51177 ADDRESS loi
<br /> 1410 South American Street Slockmn,CA 95206
<br /> H.TANK DESCRIPTION
<br /> "TANK ID I: 112 T,\NK M,WU FACI'I.IR III( .11; 'r,\NK(0N1'IGCR,\I1Or. 'r1HSl\%Kls Of
<br /> ® I A31'ANI!-,V,ONE 1,\N'K
<br /> Unknown ❑'.ONE IN:\CONpU1i T1n.\(I':OIMF.
<br /> L"i:olcl,ons eu un
<br /> fol. n
<br /> ufll
<br /> DATE US"I'SYS'rENd INS'I'ALLED +" 'TANK CAPACITY IN GALLONS fl-, NIINiRER OII COhll'r\R Ir\IrN'FS IN'I'IIE UNIT t!l
<br /> Unknown 150-500 ONE
<br /> III.TANK USE AND CONTENTS
<br /> TANK LIST-, M,.\I(\IOR VHHCI.E rI:I11.1\(I ❑ ItL U:m,\,\Fit I-"INC ❑ Ic.-M\'TION fCELING .13"
<br /> ❑ ?.('Ill:\IIC11.PRO[)((P NVOR.\(R' ❑ I 11\/..\RDOL S i\'As1 ,n inJn I-,.a Oin ❑ i LIIEIt(fE.\('F GENE.( lOR N'11.1uu
<br /> ❑ 1, (IIHFR GUNFRAI'OR I'CEL ❑ 'K.UNKNU\Y\ ❑ 99.OMEl( lSPccif r 1\":'
<br /> CON'I'LN)'S PrIROLFIII ISN W.REGI iL.\R 1!NLE:\IIf.D ❑ Ict iloolz ADE LNLI::\Oto ❑ II,.PRI_WIL\I L'SI,r:WED "In
<br /> U D1rsGl. ❑ < 3rr r'.a::L ❑ '. ;,CI\naO G,\i
<br /> ❑ ri.v 1..17HOLLtN I3l.fiND I L U. ❑ 0,1,1(lin vi Il(OLFt%I rs'.6tp_ rbp,
<br /> NO\.PrrfoL Fit-,1 ?.I�SrD OII. ❑ll.,.ETHANOL
<br /> (]
<br /> it ollnfR NUI(�I'I:'I'ItOI-P.1:\I is nxif'1: a"'C
<br /> IV. TANK CONSTRUCTION
<br /> 1'1'1'11 OF1 AN K IS LSIN(II.I!kk AU ❑ ' D(WIR EN'AL f. ❑ ";.CNKNOWN a,!
<br /> PWNI:\RV('O L\IV\Ili?:I' N I SFi[P.1. ❑ : IEll ntil_:1S5 ❑ r:.l\'MIZ\:\L t31.,\)DER ,aa
<br /> ❑ '.S'lliE.l. 1\'nLR\:\L 11\1\6 ❑ 9?.s \,Kxo\Y\ ❑ w) Ortwk !Sparoilbl: a:,1
<br /> SECOND.M0 CONI'ANXIENI O 1.S1r:r.l. ❑3 If;pica.:\Sti ILD ,I>
<br /> ❑ urn.ND�a:. ❑ o.-nNtcNo\Ys ❑a9.u'Furrz is,<•iA):
<br /> OPP.RI'II.I.PIttNIN"IM� ❑ 1.:\cI'llmI\'K('\I \L\R\IS `.13.\11.rllf\1' tj ? rnA.'I'I!Ill"SHI 'I.OI'PCAI.\'1C ds]
<br /> ❑ 4 \\K%li l':r„ ,11 L\11:',I.,I OR LMAIPIION I ROM O\PRI'1I'l.PRIR'I:NTIW.ip1 1I'\IEST
<br /> V. PROI)UCPl�N'ASTEPiPINGCONSI'RIIC'S'ION
<br /> PIPING CONSIRL)CHON I.SINi3I l:-'.I \LLI:(D ❑3 DDI1131.I_A'\I.LED ❑99.Ol'IF!IT a'u
<br /> SYst-um]'VITT IRLSSI:RI' El GRACl'1'\' ❑ ; (I1N\ti'HONAI.SU(-rION ❑ a SAI I St('1'10\f!ICL'It;,%,4ag!ll :q
<br /> P1t 111.1R1'CGNI';\I\IIIiNa' (] I.s ISI:\. ❑ I.FI131711 .:\4S ❑ s.f1.L.CIIH.1: ❑ I0 RI(llDl'1..mic 161
<br /> ❑ w, \o•i. ❑ ,,: I.'\KNN,M\ ❑ •:,:, OIHLRISP1CIk): Io"a
<br /> SECONR\RV'('11AI't;AAIiAI' ❑ I NI EEL ❑ 111111 ltGl..-ASN ❑ v 111Nil 6' ❑ I9 RIUIDI•l Situ' .ton,
<br /> ❑ 9n :\CNP: ❑ ,>5,l'\K:NON? ❑ •a i311!lilt 4NP•'cil)'): An:c
<br /> PIPING-In IBINI ('0\1%1N\u NI SUMP I'YPI F.41SIit.li\\',111. ❑ ].DOL:1131.E W:\LI, ❑ 'It' \oNL: anaa
<br /> Vi.VENT,VAPOR RECOVERI'(VR)AND R(SER/FILL PIPE PIPING CONSTRUCTION
<br /> YENTPRl.\L\RY('f)N1:\INMFNI LSl'Ff;L Lf113GRGl.:\SS U TO RIGIDI'LAS'rl(' ❑ 141 NON1': El 09.01 H[R(SpcciFi a•.(<
<br /> l:da
<br /> \'ENT SECOSDAR I'CON r:\1NNIENI' I .STrm ❑ I.rIDIiRGLASS 0 Ill IRMIL)PI.:\SI'IC EI 80.\,mfS ❑ 'l') O HIER(SPecili, ICU
<br /> Au1i1
<br /> \'R PRIMARY CON'I'AINUH>'I' I.SI'Elil. 0 J.I'MERGLASS ❑ 10.RIGIDI'L:\SrtC cg ,,,,N(1\1 0 M.01'TIER(Sp,6N, „)1p
<br /> If,lh
<br /> KR sE('Ommm CIISL\1NUr N'r ❑ LSII:EI. ❑ 1'r IRERGLA." ❑ 'o RICIUI'L:\S'I'IC 'nl SONE ❑ 9'I OI'3IER Npecil;) uah
<br /> L m,
<br /> \'EN-1 PIPING'I R.\NSI ZION SU\ll"TYPE ❑ I.SINf1.E V\ALL ❑ .'. DOURLUt\'M.L 0 6o.NOSI:
<br /> RISER PRINT W (-(IN I "NNU.N1 Li I srifw.I. ❑ 4P113P.RGI-\SS u a M(FI)PL:\S'1'IC B '10.NONE? ❑ 99.OI HER ISp.flfj) I'>b
<br /> di til
<br /> RISER SECOND:V(Y(ON I'AINMI.i NI' ❑ I.SII'.I:L CI I.F113ERCLASS ❑ 10 RIGIOI'Lwic ea \ONr: 'w.OI TIER ISP.ir) G.tk
<br /> 1614.1
<br /> PILL CU\IP(i\F:NIS I\SL\LLEU ❑ I..SPILIARICKE.I' ❑ 3.STI(IKI[R'PL:\Tr I3OI'l a\I'I'Ri>I E('r0R LC0Nl':11Nv1I'NTsL1\II' 4111,
<br /> -V-1 1.UNDER DISPENSER CONTAINMENT(UDC)
<br /> CONSTRtX1ION"I-N PC C1.SNCLP.WALL [1 1.DOU13LL\NALL a 3.\O DISPENsm El go.NONE '11611•'
<br /> CONS'rIiCC'IION'\L41'I Fum. ❑ I.S1 HIL ❑ A.PII3FRGLA55 ❑ to RIGID PLASTIC ❑ Oo.GTI WR(SP.cifr) 11"6.1
<br /> VIII. CORROSION PROTECTION
<br /> STI7EL COUPON ENIPRO'FEC I ION ❑ 2.SACRIFICIAL ANGDE(S) 0 .1.1\II'ItESS150 C'LRI11i Nl' ❑ ..ISOLvrto\, As.
<br /> IX. APPLICANT SIGNATURE
<br /> ci,.wril'1C':\TION: 1 certify Hort This US'I'srslem is cnmpnlilde rvith IILe para rdnns sn6sunce stored:md Finn the in Otrniation provided herein is true,accurate,
<br /> and in fall compliance is ith legal ie i irrments.
<br /> APL N'I' •IO DATE
<br /> A 'LI ' :'TNANIE(print) nII APPLIC'ANTI'rru.- 'rosin• ���
<br /> Reba Win
<br /> VPCP US'r-R-I!2 Rev.(12/2007)
<br />
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