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l Dni�a-a I-�3 ' vIFIED PROGRAM CONSOLIDATED FORMI TA0202006 UNDERGROUND STORAGE TANKS - TAN5 av/ FAC#:PR#' FAo00376 ( ; (two pages per tank) TYPE OF ACTION ❑ INEW SUE PERMIT ❑ 4AMF\DLD PERMIT Page9 of5 (kik oni Ban aey) ❑ 3CILW GF OP INFOKMATION ❑ 6 TEMPORARY SITE CLOSURE (5pc,lyrown-fw lwzl we ❑ 7 PERMANENTLY CLOSED ON SITE eeawn-fo,lwil ucw ❑3RENEWAL PERMIT may) (ea,l% _ ry). ❑STANK REMOVED uo BUSINESS NAME(Samcas FACILITYNAMEM131 Wing a,ain,ss na) FACILITY ID: PH#: JOHN TAYLOR FERTILIZER" FA0003767 PR0232020 LOCATION WITHIN SITE(opd.I) 1819 S ARGONAUT ST,STOCKTON al PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildmgs and laudnlasks shall be subinhand to the local agency.) TANK ID# Tank#: 5 412 TANK MANUFACTURER 453 COMPARTMENTALIZED TANK ❑Yes ❑No 434 TA0202005 I TiO TANK If•Ym;,mnPlmcmmpa9efafiockwtroat L DATE INSTALLED(YEARMIO) 435 TANK CAPACITY W GALLONS 456 NUMBER OF COMPARTMENTS 4J7 8.000 ADDITIONAL DESCRIPTION(Fm I.I me-ly) 439 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 4ao ® L MOTOR VEHICLE FUEL ® Is.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Ifmukd m^PMC P,00k,an Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑4.GASOHOL ❑ ".OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAMEfiam Hawdom Matcriala lm ❑ 4.HAZARDOUS WASTE ( miory Fa9e) ul CAS#(Ram Hazvdom Maiaials mvmtory page) 442 (Iecludm Usd Oill ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 413 (mak oac lion oiy) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIA.-primary Tank ❑ 1.BARE STEEL ® FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 41"4 (Clot m.nva muy) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ® 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 (Ck,k aro iwn oNY) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS [:18.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ HI COATED STEEL ❑ ".OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ LRUBBER LINED OR COATING ❑ 3.EPDXY LINING ® 5.GLASS LINING El95.UNKNOWN 4a6 DATE INSTALLED M7 (Chale aac�um aNY) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ❑6 UNLINED ❑ 99.OTHER (Fa bd ueady) OTHER CORROSION ❑ I MANUFACTURING CATHODIC u9 PROTECTION IF APPLICABLE PROTECTION ®3 FIBERGLASS REINFORCED PLASTIC El95IINKNOWN 449 DATE INSTALLED (Cnak orc ium 9Ny) ❑ 4 IMPRESSED CURRENT El "OTHER ❑ 25ACRDTCW.ANODE (Falonl me my) SPILL AND OVERFILL YEAR INSTALLE45o TYPE(Innlotti 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chale as da Wpy) ❑ I SPILL CONTAINMENT ❑ IALARM ❑ 3 FILL TUBE SHUT OFF VALa ❑ 2 DROP TUBE ❑ 2 BALL ❑4 EXEMPT ❑ 3STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A dasnpokaofdc inomnia9pm4mm aluu h,sanmitwl to de loci IF SINGLE WALL TANK(Cneek all din apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chat one itrn any) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 El Yes El No UPCF(12/99 revised) - 1./ `I