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T,Ink2 I1(:1'. UNIFIED PROGRAM CONSOLIDATED FORM UNDERCROUNDSTORAGF.TANK OPERATING PERMIT APPLICATION-TANK INFORMATION lone rano •r CSI TYPE.OF ACTION IC'hcek unc item only. For yl 1'ST pemunenl clnsme nr lenlornl.uompleie only This seclinn and Scelions 1.IL 111•iV.and IX helms I "'• ❑ I NI'.W'1'Elthtl l' ❑ IJtt;NEWALI'MMI1' i ('l1ANti:11FIKFORMAIION' 171 6.TEMPORARY USTCLOSURE 0 7.UST PL'RMANL\P C'LOSURii ON SITE 0 K.UST REMOVAL IIAI f.LN'1PLRh1ANIiN 1'LY l'Ll1S1iU: 1• "0'' 1 OAI It I-XIN I INC USI'OINCOVI-RI-D: I. FACILITY INFORMATIONFACILITY IO d I.Igaa) Use 040 __ III IT BUSINESS NAME(Same as FACILI"IN NAh1E or DDA-Duinf.Busincis As) Costco Gasoline(Loc.No.1031) UUSINLSS SII L AOORLSS 4141 ('IIT I"' 2440 Daniels Street Manteca 11.TANK DESCRIPTION 'IA\K 11)0 "' T:\NK%1ANIJ1A('7t K EVE I" �I',(nK tnNH(;tlRAII0N. I'mirASKIS Q I.:N.1INNO-AI ONO TASK 2 ConlainmanlSolulions 02.0vI (NA4,6\IPARInn:Nn:himr. ' [ongLl:+m rv:F_hv:nA,:rvywne m m n.e uul DATI:USTSYSI Eht INSTA L LED �'! 1)\NK l'AIb\l'lll'IN<iALIONS "° NUMIII:R OP C'OMPAR'I'hlliN'IS IN'I'111:U\II' "' AuOusl 2008 30.000 1 111.TANK USE AND CONTENTS TANK USI: O In M0109 VC1111I F FIIEI-INTI ❑ Ih MARINA IFEI INO ❑ IV AVIAIRiNF111-11NO J1, ❑ ).12111F.It l PRODUCT STORAGE Q 4.1 AZARDOI IS WASTE 1140ido l'.ua Gill ❑ 5xi,1171WENCI'(&NERAToii Fun list-t±>]sI S,.'I ❑ NOTIF:R: ENERATOREL 95IKNOVsirr l: (� n KFlillAll:VlI:AOtD ❑ h MIIGR1ptI�VIE 'Nil-Alm) CUNTENIS 111I:N) 19 KM, I '41'41 "'• [13,DIE°SFL O 5.In FCV,L ❑ n.AVIATION GAN n,PFI RUI Fl:M 111 pN11 1'11.1 ❑ , O111FIt PPI'1tUIItiV NON•PF18011"t 71fSFO UD la FfIIANI II 11.OTHER NON.I`E1'ROLEVNI Smclfi: 4+Im IV. TANK CONSTRUCTION '11'1'E OF IANn ❑ I.MNGIRWAIL IN I.00URIP\Y:1LI IJ'i5.1'4-"' 'N OI PRIMARYC(iNIAINWN1 LNIEIi4 • (.FIHERill ACN " IN IFNV 41 NI Al1llElt II ❑ 1NIEEL•Ih'7 P.RNAL LINING ❑ V5.L tl' ❑ 1V,UI IILR IS mer ryl: Ilu SICO.NDARYI.ONt AINMhNI' ❑ LS11:1:1 Q) Flril•NUTAS.S ❑ h IAII RIIIIt\II MBRA VL IINI:N 11A(XPIIU VR NONE '15.LINKNlH1'N 'V.f) IIPR LS I�u 1 aa)n OVIiRI'ItI I'RF\'fN 11OV 19 LAl1UiRIFk INIl.A1 AI AR\IS ! Ila f All FI 11AT • f Fit 1111111'Slllli•IIFF VALVE ❑ 4.11ANK MEEISRE uinivi ris FOR EXEMPTION FROM OVERFILL I'REVI:'NIION EOt'IPh11iNl' V. PRODUCT I WASTE PIPING CONSTRUCTION rill-INC C'OCSTRUI,IION 1711 SINULHAVALLE•D ].O0001 E-1s':\LLFU '>D.OTIIFH 411 Nl'STFnI T\`I'L' Q 1.PRENNt'kE ❑ !.t1R,\1'I'r1' Q ).l'ONVCNTION.AI.St'l'II(1N ❑J.SAFC SIR')1f1N ritt'R ueur I'klntAll\'('IINI'AINhIFVr 1.SIEFI • 4 FILIFRGt ASS ItFI F'Nimt, IR NI(i101'1 ASPIC '^' Q 911.NON1 ❑ ll UNKNOWN 9n.011il NlS mnfi SF.CONIM CONIAINI II!NI ❑ LSI1tliL D 4.1'IDCROLAS$ ❑ N.ELN., L IU WGIDPl MSIR Ain Q 9IL NONE 095.tINKNOIV'N ❑uV,OTI(ERIS msl 1. �ti' PII'Lulnll'NHINE('11h 141NhIFNI'smil'IYI'F LSlhllll W'ALI. • 1.OUVHI F.\TALI. Vp Numm. ("+� VI.VENT.VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION \T hI PRIw"CONIAINMhN I' 1.SIFL'I • J.FIHFNIi1.AN5 IP RIGIOPIASI it '/1LNnNL VV(11'DFN ISN:11}1 anal VI:NI SECOVOA)I\(1)MAINNIENI ❑ I.SIIAL. M 4.IWI-Wit.AM In I(11HD1'I ASI IV Lj 711 NONE U lu 011miti5pe.11)) Ih ill VR PkIh1ARN(Thai AINNIFN1 Q 1511'1'1 fj 4.F111 Rut ASS U IR RIGIOPIA9111 'UI.NOW WOU1FKlSpeafyl Ilii VR SR ONOAHY L'ONTAINMI:Nr .I.sNE ■ 4.FIBERGLASS TAN'Tit Ill.KIMI) VII.NONE 0 91.0TIIER ISK iryl {'•+t 4e1k1 VCNI PII'INO TILA.NSI CION SUMP'(YPE I.S1N(I.Ii W`ALI. Ic 2.IK)t101.1:Nall. It151:K I'RI1fAH1'IUNIAINNII:NI • 1.hI lail. 4.LIH1-KAHA5S It,HKIIOPLASI1l 911,NI1N1 9'LO'lliEl INpecil'yl 4'41 1.11 ltl,SI:RSI:EONDARYC(INT,%imr.1ENI 0 I.STVEL4.1'm1:R(11.1SS u ill RIGIDKASIR Ll 911.NONI TTMI1ERISp-im IWL Initl 111.11'OUPO\.h rSI\SLN II'D IN I.Spil1mICKET • ),NII(IK )tPLA11i I)OTTON PItOTF(TC)lt • 4.('ONTAINNIENTMINIP '•"` VI1.UNDER DISPENSER CONTAINMENT(UDC) t ONSINI-VilthS tYl'r•. 0 1 5I.1411 It WAII 0 ' IN Ii N'AI1 0 t hitIIINPI NSFRN ❑ IRI NONF -rN. l'ONSI RI'lT1ON N1A111MA1. Q LSTI!L:1 IUEKWANS [, 11'IIIGIOPLA.I'1i1' ❑ 1n,O1111:R 15 cifyl °•'n'• Vlll. CORROSION PROTECTION SII:FI COMPONI-VI Vii ECI 1011, ❑ 2 SACRIFICIAL ANODI•IN) ❑ 4 I\I I'KFNShU('I'KHI+VI [1 n.IS(DAI]ON IX. APPLICANT SIGNATIIRE C'F:R'I'IFI('A'1It)N; 1 eeniR that this UNI x)sttm Is cnmpalihle)rith the hntardnus snhsmnce rimed nad Thal the infarnwllm)prnrided herein Is true.accurate• and in roll eom I•ace With Ie a1 re uirrmenU. u9 APPLIC'AN"Iat;p\% 'll DATE 0 iii w APPI 1(-A TTITII, r\1'1'1.1(':\S'1 .:1Mh.q)nmi DavLon I Dirtil of Real Estate Development F I.1'F l'N'1'-It-It' Rvr.112/2007)