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ED PROGRAM CONSOLIDATED F ( 3 V 1 UNDERGROUND STORAGE TANK 3 7� OPERATING PERMIT APPLICATION-TANK INFORMATION(one form per UST) OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections L 11,BI,IV,and IX below) 430 I.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE LIST PERMANENTLY CLOSED: 4301 DATE EXISTING UST DISCOVERED: °ion I. FACILITY INFORMATION FACILITY ID#(AgencyUse Only) Q 0 g � 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Tower Mart#876 BUSINESS SITE ADDRESS 103 CITY 1oa 14000 E.Hwy 88 Lockeford,CA IL TANK DESCRIPTION TANK ID# RU-876 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 A 0�63 O Modem Welding E1.ASTAND-ALONE TANK El2.ONE IN A COMPARTMENTED UNIT. C lm oce pagefor each co in the uvit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 Jan 1991 12,000 Gal One I III.TANK USE AND CONTENTS TANK USE akr&MOTOR VEHICLE FUELING ❑ 1b.MARINA FUELING ❑ lc.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(r6ck k.Ured 00) ❑ 5.EMERGENCY GENERATOR FUEL(HSC§25281.5(c)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 43% CONTENTS PETROLEUM: lkia.REGULAR UNLEADED ❑ 1c.MIDGRADE UNLEADED ❑ Ib.PREMI MUNLEADED 449 ❑ 3.DIESEL ❑ S.JET FUEL ❑ 6.AVIATION GAS ❑ S.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440a NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUMS 44% _JV. TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL Fer2.DOUBLE WALL U 95.UNKNOWN 443 PRIMARY CONTAINMENT Dk I.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (specify): SECONDARY CONTAINMENT ❑ 1.STEEL ❑3.FIBERGLASS RPS7EXTERIOR,MEMBRANE LINER ❑ 7.JACKETED s45 ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER S ify: 445e OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT 3.FH.L TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑1. INGLE-WALLED .DOUBLE-WALLED ❑99.OTHER 460 SYSTEM TYPE 1.PRESSURE ❑ 2. RAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 23 CCR§z63 4 3y 458 PRIMARY CONTAINMENT [11.STEEL 4.F®ERGLASS [3 8.FLEXIBLE ❑ 10.RIGIDPLASTIC ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Spec]fy: 454 SECONDARY CONTAWb1ENT ❑ 1.STEEL aK.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 4546 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464` PIPING/TURBINE CONTAINMENT SUMP TYPE .SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE �d VI.VENT,VAPOR RECOVERY(VR)ANDER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT .STEEL 4.FIBERGLASS ❑ I0.RIGIDPLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464e a5x1 VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(SPeciry) 464f 46411 VR PRIMARY CONTAINMENT L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4648 464 1 VR SECONDARY CONTAINMENT ❑ I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC EI 90.NONE ff 99.OTHER(Specify) 461h 464h1 VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE �', RISER PRIMARY CONTAINMENT ❑ 1.STEEL .FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE 99.OTHER(Specify) ii 464'1 RISER SECONDARY CONTAINMENT ❑ 1.STEEL El 4.FIBERGLASS ❑ 10.RIGIly PLASTIC 13 90.NONE Ej 99 OTHER(Specify) 464' 464k1 FILL COMPONENTS INSTALLED 1.SPILL BUCKET ®'1.STRIKER PLATEIBUTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP 451. VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE 0T.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469' CONSTRUCTION MATERIAL ❑ L STEEL ❑ 4.FIBERGLASS 0.RIGID PLASTIC ❑ 99.OTHER(Specify) 4696-c VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ❑ 6.ISOLATION 448. LY. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in full com liaace with legal uirements. APPLICANT SIGNATURE / DATE 3/3/08 470. APPLICANT NAME(print) Paul Chevalier 471APPLICANTTITLE Maintenance Manager 472 UPCF UST-B-V2 Rev.(1212007)