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�IFIED PROGRAM CONSOLIDATED FORTANK: TA0507801 PR#: PRO507806 UNDERGROUND STORAGE TANKS - TANK P GE FAC#: FA0007770067 aL1 two pages per tank) /l q Page 2 of TYPE OF ACTION F-1INEW SITE PERMIT F14AMENDED PERMIT ❑ 5CHANGE OF INFORMATION E]6IFEMpgs,7 OR SI LOSURE (Chxk°^1>''m1 p1I>'1 ❑ 7 PERMANENTLY CLOSED ON SITE 6pc Ins oo rorlxN muonl;l USW ftrcsswrro al us<°nhl ❑ 8TANK REMOVED 430 ❑ 3 RENEWAL PERMIT BUSINESS NAME Isameas FACILHYNAMEarDBA-Doing Bminess As) FACILITYID: PR, FLIGHT SUPPORT 3 FA0007770 PR050 M LOCATION WITHIN SITE(Optiow) 6364 LINDBERGH ST 202,STOCKTON 431 PHONE I.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# Tank#: 1 432 TAMC MANUFACTURER 433 COMPARTMENTALIZED TANK ❑ yes ❑No 434 TA0507807 FLUID CONTAINMENT R Y .rompine p go oro w pmarcnt. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 12,000 AUDIT 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 040 ❑ 1.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (IfmarkW mmplvM1e Peaolemn T.q:) ❑ I b.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ® 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADEUNLEADED ❑ 4.GASOHOL ® 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(6°m Fbaardous Mmmals Invmurr page) 441 CAS#(fi°m FiaaNwu h1 axials bvenmry page) 442 ❑ 4.HAZARDOUS WASTE (anew.Used Oip ❑ 95 UNKNOWN HI.TANK CONSTRUCTION TYPEOFTANK ❑ I.SINGLE WALL ❑ 3.SINGLEWALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Cheri are item only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN M 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ❑ 1.BARE STEEL ® FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 446 (ehcckwciannonly) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD WTIBERGLASS ❑ 8.FRP COMPTIBLE W/IOIk/.METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL M 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chwk mwia+n only) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLADW/FIBERGLASS [j 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATEDSTEEL El 99 OTHER ❑ 5.CONCRETE TANK INTERIOR LINING447 OR COATING ❑ 1.RUBBER LINED ® 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED (CM konohunwl.) E]2ALKYDLNING ❑ 4PHENOLIC LINNG ❑ 6UNLINED E] 99.OTHER (Fw IoW uu ml3) Us OTHER CORROSION ❑ I MANUFACTURING CATHODIC M 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN as DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION ❑ 4 IMPRESSED CURRENT ❑ 99 OT14ER (Checkmoiterwly) ❑ 2 SACRIFICIAL ANODE (For bol me only) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(Icolusmly) 451 OVERFILL PROTECTION EQUIPMENT.YEAR INSTALLED 452 (Chale allthmapply) ❑ I SPILL CONTAINMENT 1,998.00 ❑ IALARM ❑ 3 FILL TUBE SHUT OFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑4 EXEMPT ❑ 3 STRIKER PLATE FLOAT N.TANK LEAK DETECTION(A description oftla:monitoring pmgrwn shall be-anot ad tothe Incl agmcY.) IF SINGLE WALL TANK(Chcck alltlm apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Gheek meitem only) ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) [j 1 VISUAL(SINGLE WALLINVAULT ONLY) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ 3CONTINUOUS ATG ❑ 7GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ 8TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE IN FORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITHNERT MATERIAL? 457 '1 7 O �_ ❑Yes ❑ No UPCF(12/99 revised)