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1IFIED PROGRAM CONSOLIDATED FORA,," / / /�,� ..O KANK: TA0160405 1`.D/I/ �L PR#: PR0231604 UNDERGROUND STORAGE TANKS - TANK PAGE 1 W p1� FAC#: FA0000650 -0, (two pages per tank) Page 2 of 7 TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION E] 6 TEMPORARY SITE CLOSURE (CL Mlyitmmy) ❑ 7 PERMANENTLY CLOSED ON SITE ❑3RENEWAL PERMIT (BPmy Baa-far"we only) (SPn+fyrawa4ataa1n 0*'1 ❑ 8TAW REMOVED 430 BUSINESS NAME(s.wna FAcam NA wMA-Dm V B®lnas A:l FACILITY m: PR#: JIMCO TRUCK PLAZA' FA0000650 PR0231604 LOCATION WITHIN SITE(ool ) 1022 E FRONTAGE RD,RIPON 431 PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location ofthe UST system including buildings and landmarks shall be submitted t3 the local agency.) TANK ID# Tank#: 5 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Y<e ❑No eN TA0160405 H've'.amPla4 on<vae4[w®mvN®w. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 430 NUMBEROFCOMPARTMENTS 433 1,000 ADDITIONAL DESCRIPTION(For ml merry) 438 U.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ❑ 1.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑2.LEADED ❑ 5.JET FUEL 1R1wkN®Plae Pmuksmtypq ❑ Ib.PREMIUMUNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ la MIDGRADE UNLEADED ❑4.GASOHOL ®99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME m,aa xaar4im Maaiab lamaawr page) 441 CAS#(6wn H.vraam NM mvanwy page) 442 ®4.HAZARDOUS WASTE (IwBdaf csl) WASTE OIL ❑95.UNKNOWN ID.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (CMt meimn muy) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ 99,OTHER TANK MATERIAL-primmy lank ® 1.BARE STEEL ❑FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (Cms wwa Y) ❑2.STAINLESS STEEL ❑STEEL CLAD W/FIBERGLASS ❑B.FRP COMPTIBLE W/UX?%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-sewada y tank ❑ I.BARE STEEL ❑3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN a5 (C we ban my) ❑2.STAINLESS STEEL M 4.STEEL CLAD W/FIBERGLASS ❑8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ S.CONCRETE TANK INTERIOR LINING ❑ L RUBBER LINED ❑ 3.EPDXY LINING ❑5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 442 OR COATING (Cncx uan aHyl ❑ 2 ALKYD LINING ❑4 PHENOLIC LININO ®fi UNLINED ❑99.OTHER (Falml meoNy) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 4411 DATE INSTALLED M9 PROTECTION IF APPLICABLE PROTECTION (Cmd�wsit®Wy1 ❑ 41MPRESSEDCURRENT E]99 OTHER ❑ 25ACRIFICW.ANODE (Fwlml meaNy) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(local meaay) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (CMt vi Wu+PPN) M I SPILL CONTAINMENT 1,991.00 ® 1 ALARM ❑3 FILL TUBE SHUT OFF VAL' ❑X 2 DROP TUBE 1,991.00 ❑ 2 BALL ❑4 EXEMPT © 3STRIKER PLATE 1,991,00 FLOAT IV.TANK LEAK DETECTION(Ad ,awnofaa:manlmans woPa11emu ma nwuoi m mnlocal,ae.y.) IF SINGLE WALL TANK(CMsr N ala apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 4% ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIA.MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIA.TANK TESTING ❑99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE T Ucvn(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FBlED WITH INERT MATERIAL?No as) 5 ❑Yea ❑No UPCF(12/99 revised)