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Tank1B(IL: 01•^,919 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGF.TANK OPERATING PERMIT APPLICATION-TANK INrORMATION ionefortriverUSTI TYPE OF ACTION ('luck one item only, Fat ml I'STpem,anenl closure or removal,complete only this sectiml and Seclion;1.11.Ill.IV.and IX helo)vl ❑ 1 NL3VPI!RMIF ❑ ).RliNli\VALI'I'ItMIF 11 5 ('IIANtiE OF INFORh1Al ION !.TI(S PORARY LIST C'LGSCRL' El 7.CST PIRMA`L'.\"f('LOSCRIi ON SITE n x,L19T REN OV AI. OA 11:USI PkIMANEN I'LYCLOSIi): 110' UA'I1%I-XIS I ING CSI'DN'C0V'I:RFO: 1. FACILITY INP'URMA'1'ION -T-FTT L7 FM ILITY ID N I:Igrm l 19e UnA) BUSINESS NAME(Same us FA('ILvrY NAh1E or DUA-Doing Business As) Costco Gasoline(Loc.No. 1031) BLISINLSS SII L'ADORLSS '"' CIIY 2440 Daniels Street Manteca 11,TANK DESCRIPTION 'I ANK IOC "' TANKMANUFACIVIHR "' I A I AINFIDI IRA I urN:THIS 1'ANK Is []LANI AND-nI(Al IANK 1 Containment Solultons ❑?ONl'.IN At OMPAKINILNI kU PNI I. DA'11:USl'SYS'11iKiINSTALLED IIs TANK CAPAC'I'I-YIN GALLONS a!° NCMBI:R OF C'OMPARI'MIiN'fS IN'fHI:UNI"I' y11 AuClus12008 30,000 1 Ill.TANK USE AND CONTENTS 'I ANK UNI` Q Is N101014C VlDICI L 1'111-1 IN(i ❑ Ih MARINA H'FLIN(i ❑ Ir AVIAIION FOFI IMI J19 ❑ 3 COFMICAL PRODUCT STORACIF ❑a.IIAZAItIX)PSN':\STh On.NJ..16aunill ❑ 5.FhIF.RGFNCY OF.NTRATOR FDRI pIsc 052.15nq ❑ .t1M:ONERA1ORFUEI, . ❑ ')5AINKNO\\N ❑ 44h,OTI•IMFR I9 .1 I: PEIh _ : IN la9k.(iI11AR1VI1:AU40 [) IrMIDORA*,UNll'AD ❑ IrRlIPhIINIIaI*JJW" (UNfFNTS ItI :IF [1 ).DIFSFI ❑ 5AFTYCEL , ❑ A.AVI.ITIOVOAS ❑ N.Plrrlt(x Ill PND 11:11 134,DTH FR PFTtt01 NDN•P1'1H011!M 1.I,NPU t)II III,FI'l1ANt11 ILOTIICR NON-PL 11tOLPi'\I tS rlh: tut. IV. TANK CONSTRUCTION 11'1.11 Or TANK ❑ L SINGI r\\'.AI.I. M '.DOIIRI F\\•AI I L3 45.UNKN(M.N In PRINIARYCONI'AINAII:NI ❑ 1.51111-1 aI.FIRLRULASS U h ImrKNAL.RIADDL'k ❑ 1.9FIiEL INI ERN!\I.LININO ❑ 4S.UNRROW'N ❑ 99.11 L.R (SPirifrl: J{I, SI CONUAR\CONIAINKIP.NI ❑ 1.511:111 ®.1.1'1111 R61 ANS ❑ o .IL11OR\II NI11RAVl IINI:k ❑ l Ir\I KF IIU 'te 112 HONK '15.IINKNl1\\:\ 4V OIIIPH IS .01" JJSe OVFRI II I PRI49-N1'ION I.AUIIIRI F R\'ISIIAI M Alt\B ❑ '.RAI 1 11 OAT • i.FII 1.111111-SIRIT-01T VAI VF a52 ❑ 4.'FANK MEEM REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EOUIPMEN F V. PRODUCT I WASTE PIPING CONSTRUCTION PIPING CONSTRUCt1ON LLFD _ UOLLE-WAI.L❑I3.(Y1K\e'LOK1I0IFRA❑NYNTLNf IY1H; LMF SA\ITlNLSUtIION A SAIL SIR'OON I2,uXree,ry�kN IIM1 PlUMAkYC0NI4AINhI1.N1I,SIFFI QJ DilFRlll ASS U HFI F"I1lF U 10 RIIiIU I'1 AM It 4n.N 11I ❑ 4f.116KNtMN ❑ 40,()1111 R(N nfyt 1"I+ .SLC()NOARI'l'(IN LCINh11:N 1' ❑ 1.5T 1!LL Q J.1'IRCRGLAS9 ❑ N.I'I_ICU({LL ❑ IU 11I011)I'Lr\511[ Ibl1• ❑ 40.NONE ❑ 45,UNKNOW'N ❑ 44.01HER(S,, ( I. dCJ' PII'LVt PII�RRIVL('11N 141NMLN151'AIt-IYPF I.SINCH E WALL • 7.DOURI h NAIC1 4tI NONI. Lod VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION 1'tKI I'NIMANI'('(1NfAINAi1'V I' ISfljlq • 1.FIRF.NIiLASS I D NIIiIUI'1 AWk U VII,NDNp 44(YI'flL•'N(SryYd)I aLw an \'FNISLi1)NI)AItYlIWIA114Mr.MI ❑ 1 SILLI Q J 198I:1UL:1S4 10 I1161DPIANi R' ❑ 411 NDNL C1 -)'I 011II:K ISPr:H)) J=m VN PRIMARY CONIAINNIFNI 0 1S11+1 I9 J.FIRMA ASN E) III RIfiIUI'I A5111 Oil NON( 4U 0 UIl`RISrw1fYl 1"'( imo VK SLI ONOARYCON TAIMUNf 0 LSTI:1:1. J,fInEHlil.Ati lu.k GIDPLAsflt Ll 0U. O L o04-0"r P:RISpe,AI IWW V 17KT PIPING IRAN.I ION SL'AP'IYPk F1 I,SLGt.Ii WALL Let YVALL 4II.NONIi 16L RISIAPKIMARY 10NIAI,NNlrNI LSII:LI 4.11111 RGI..".1 III Kit ill 11.A,til if OU.NIIN1 'Iq Mile"ISpacifcl a'a1 PUSERSECONDARY CONTAINMENT ) ST n:I. J.FIBERGLASS Io RIGID PL\41 It a 49 NONE ')4(1TIIIfRISpr:if)I mil Is FILL COMPONENTS INSALLF.1) • 1,SPH.1.DUI"ET • �.STRIKER PLTfF05FToFI PRoTrC"p • 4,('ONTAINNIPNFSI.NII' )+• VII.UNDER DISPENSER CONTAINMENT(110C) UONNIRIVIIIIN IYK ❑ L SIVIx P NAI l ® 2 IX)IIHI E\VAI l ❑ 1 NOr11S1'.KSFRS ❑ 4n NONE +'•"+ I ONSTRUCTION\fATEIUAL ❑ LNIT11 M 4morkG1ASS Q IO.RItilUl'LAiTU ❑ 44,OTIILR)S ,d1-l Vlll, CORROSION PROTECTION SILHCOMFONFN1 PROIE 'II(IN ❑ . SACRIPICIAl ANOMIS) U J IWPRFSSPDCORRLNI ❑ n,1501 AIION 1X. APPLICANT SIGNATURE. ('EH'17FICA'l10\: 1 ftell)'that thuh CSI %)stem Is enmpall6le%I Jill the hvardnux subata ce Onred and Thal The Infarmalinn provided herein Is true,accurate, nod In full ram liancr will,lc'ol re 4lrerngny, :.v APPLICANT Sl ' 1I;LLu DAT€. J AI'PI ICANT XA\IF quint) 1" AI'Pl1CAN1 Il'l,li L David HI D ars Director of Flael Estate Development L PCP its 7._II-i,, Rel.l R!'0071