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V12,11-1 L6 �A o 520 g25 tZPc l4 . UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(One hxm per CST, TYPE OF ACTION (Check one item only. Form UST permanent closure or removal,complete only this section and Sections II 11,III.IV.and 1XhCl(,,c) 41° 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.C GE f INI'ORM9TIOS ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.U PMOV Al. DATE UST PERMANENTLY CLOSED: 431 DATE EXISTING UST DISC VERED'. - - "" 4i0b I. FACILITY INFORMATION FACILITY ID h(Agency Use Only) _ BUSINESS NAME-(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO AM/PM Manteca ENVIRONV ENTAL HEALTH BUSINESS SITE.ADDRESS 103 1a 1904 Daniels Street I Vanteca DEPARTMENT II.TANK DESCRIPTION TANK ID 4 433 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 [N LA STAND-ALONE TANK 1 Xerxes ❑2.ONE M A COMPARTMENTED UNIT. S deme e(aro hcom 4e oL 1 sn LISTS Sept Taa� LLED ZOPACITY IN GALLONS 436 O ER OF COMPARTMENTS IN THE UNIT437 M.TANK USE AND CONTENTS TANK USE M I.-MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ Ic.AVIATION FUELING 439 ❑ 3.CIIEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(IndadnUsed Oil) ❑ 5.EMERGENCY GENERATOR FUEL(HSC§252819(c)l ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439. CONTENTS PETROLEUM: IX la.REGULAR UNLEADED ❑ I,MIDGRADE UNLEADED ❑ 1 b.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.SET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM S c' aa0° NON-PETROLEUM: 7.USED OIL ❑ METHANOL ❑ 11.OTHER NON-PETROLEUM(MS eci q: u0h IV. TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL 0 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ❑ I.STEEL n 3.FIBERGLASS ❑ &INTERNAL.BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 4°4. SECONDARY CONTAINMENT ❑ L STEEL 29 3.FIBERGLASS ❑ &EXTERIOR MEMBRANE LINER t1 7.JACKETED 445 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify) a5. OVERFILL PREVENTION I.AUDIBLE&VISUAL ALARMS Ll2.BALLFLOAT 3.FILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT I WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION 0SWGLL-WALLED 2.DOUBLE-WALLED 099.Ol I1LR +60 SYSTEM TYPE I.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION H3 CCR§2636(.X3)1 458 PRIMARY CONTAINMENT ❑ I.STEEL Q9 4.FIBERGLASS ❑ S.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 4Me SECONDARY CONTAINMENT ❑ I.STELL IN 4.FIBERGLASS ❑ S.FLEXIBLE ❑ 10.RIGID PLASTIC 4Mb ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHERS ifv: 4Mc PIPINGfrURBINECONTAMMENT SUMP TYPE [1I.SINGLE WALL 2.DOUBLE WALL ❑ 90.NONE 46W VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL 29 4.FIBERGLASS C 10.RIGID PLASTIC 90.NONE 0 99.OTHER(Specify) 46"c 46161 VENT SECONDARY CONTAINMENT I.STEEL 4.FIBERGLASS ❑ 10.RIGID PLASTIC %NONE 99.OTHER(Specify) 4Mr IMfI VR PRIMARY CONTAINMENT ❑ 1.STEEL (X 4.FIBERGLASS 0 10.RIGID PLASTIC ❑ 90.NONE 0 99.OTHER(Specify) 46,1t 4&IgI VR SECONDARY CONTAINMENT I.STEEL CR 4.FIBERGLASS 10.RIGID PLASTIC Ll 90.NONE 99.OTHER(Spccify) 4Mh 4Mhl VENT PIPING TRANSITION SUMP TYPE 0 I.SINGLE WALL 2.DOUBLE WALL 90.NONE 4Mi. RISER PRIMARY CONTAINMENT ❑ L STEEL 4.FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE U 99.OTHER(Specify) ^Mi 461'1 RISER SECONDARY CONTAINMENT ❑ L STEEL 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE El 99.OTHER(Specify) 4Mk 4Mkl FILL COMPONENTS INSTALLED 1.SPILL BUCKET gg 3.STRIKER PLATE/BOTTOM PROTECTOR M 4.CONTAINMENT SUMP 451. VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ❑ I.SINGLE WALL 09 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NON 4�+ CONSTRUCTION MATERIAL ❑ I.STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 4696. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ❑ 6.ISOLATION uA. DI. APPLICANT SIGNATURE CERTIFICATTON: I certify that this UST system is compatible with the hazardous substance stared and that the Information provided herein is true,accurate, and in full com Bance with legal requirements. APPLICANT SIGNATURE Sz q DATE CR 470. 19 L L APPLICANT NAME(print) Ranfeet Singh 411. APPLICANT TITLE Owner 471 UPCF UST-B-1/2 Rev.(12/2007)