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6 42 FIED PROGRAM CONSOLIDATED F UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(one form per'u v Oso E OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,II,III,N,and D:below) 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANEN"f'CLOSoURE ON SITE ❑ 8.UST REMOVAL 47� DATE UST PERMANENTLY CLOSED: DATE EXISTING UST DISCOVERED: I. FACILITY INFORMATION FACILITY ID#(Agency Ude only) 3 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) Tower Mart#876 103 CITY 1� BUSINESS SITE ADDRESS I.ockeford.CA 14000 E.Hwy 88 II.TANK DESCRIPTION TANK ID# PU-876 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 Modem Welding [�1.A STAND-ALONE TANK [12.ONE IN A COMPARTMENTED UNIT. Co leteoneAgefteechm. m in ae mtit 437 DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 ER OF COMPARTMENTS IN THE UNIT Jan 1991 8,000 Gal III.TANK USE AND CONTENTS TANK USE la.MOTOR VEHICLE FUELING ❑ 1b.MARINA FUELING L1 le.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE UeclW-used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§u291.5(c)7 4394 ❑ 6.OTH R GENERATOR FUEL [395.UNKNOWN ❑ 99.OTHER(Specify): CONTENTS PETROLEUM:G� Ia.REGULAR UNLEADED [Ilc.MIDGRADEUNLEADED lb AVIATION 4% p->❑ 3.DIESEL ❑ 5.JET FUEL ygoa AS ❑ &PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM SOCC. NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL 4406 ❑ 11.OTHER NON-PETROLEUMS i : IV. TANK CONSTRUCTION 443 TYPE OF TANK ❑ 1.SINGLE WALL 2.DOUBLE WALL ❑ 95.UNKNOWN 4a4 PRIMARY CONTAINMENT ka 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444a ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER Species: als SECONDARY CONTAINMENT ❑ 1.STEEL ❑3.FIBERGLASS 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445a ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTkER S i ): 45+. OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT 3.FELL TUBE SHUT-OFF VALVE - ❑ 4.TANK MEETS REQUIREMvIIiNTS FOR EXEMPTION FROM OVERFILL.PREVENTION EQUIPMENT V. PE ODU T/WASTE PIPING CONSTRUCTION a6o PIPING CONSTRUCTION ❑1.SINGLE-WALLED 2.DOUBL&WALLED ❑99.OTHER ase SYSTEM TYPE (�.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§z636(aR3] 464 PRIMARY CONTAINMENT ❑ 1.STEELar4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464a ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specity): 4646 SECONDARY CONTAINMENT 1-1I.STEEL 4.FIBERGLASS [18.FLEXIBLE ❑ 10.RIGID PLASTIC 464c ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Species: 454d PIPINOTURBINE CONTAINMENT SUMP TYPE I.SINGLE WALL ❑ 2 DOUBLE WALL ❑ 90.NONE VL VENT,VAPOR RECOVERY(VR)ANDRISER/FILL PIPE PIPING CONSTRUCTION 1.STAEL ❑ 4.FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE 99.OTHER(Specify) 464e VENT PRIMARY CONTAINMENT' 464e1 464f VENT SECONDARY CONTAINMENT Li STEEL. ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTFIDt(Specify) 46411 464g VR PRIMARY CONTAINMENT 1.STEEL 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE 99. ER(Species) 464 1 464h VR SECONDARY CONTAIlNM4E<iT ❑ 1.STEEL 4.F18ERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.07IIER(Specify) 464hI 464i. VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464} RISER PRIMARY CONTAINMENT ❑ L STEEL 4.FIBERGLASS mea.PLASTIC 90.NONE 99.OTIIDL(Speedy) 4641 464k RISER SECONDARY CONTAINMENT ❑ I.STEEL ❑ 4.FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE 99.OTHER(Specify) gbdkl FBI.COMPONENTS INSTALLED I.SPILL BUCKET 3.STRIKER PLATE/BOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP 45h. VII.UNDER DISPENSER CONTAINMENT(UDC) 469. CONSTRUCTION TYPE ❑ 1.SINGLE WALL ❑ DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469 CONSTRUCTION MAT1TiIAI• ❑ 1.STEEL ❑ 4.F®ERGLASS 10.RIGID PLASTIC ❑ 99.OTTER S dy) VIII. CORROSION PROTECTION 448. STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODES) ❑ 4.IMPRESSED CURRENT ❑ 6.ISOLATION IX. 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 con liamee with 1 al r uirementS. DATE 3/3/08 410 APPLICANT SIGNATURE _ / - ��L 412. APPLICANTNAME(print) Paul Chevalier dn. APPLICANTTTTLE Maintenance Manager Rev.(12/2007) UPI USTI-12