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IFIED PROGRAM CONSOLIDATED FUIP TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page_L of 5 TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE ❑ 7 PERMANENTLY CLOSED ON SITE (Check one Item only) 430 ❑ 3 RENEWAL PERMIT (Specify reason-for local use only) (Specify reason-for local use only) ® 8 TANK REMOVED 1 BUSI NESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 FACILITY ID: Tosco#256981-Pacific 76 431 LOCATION WITHIN SITE(Optional) South side of site 4707 Pacific Avenue & March Lane, STOCKTON 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# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ® No 434 1 Modern Welding If"Yes",complete one page for each compartment. DATE INSTALLED(YEAR/MO) a3s TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1988 12,000 ADDITIONAL DESCRIPTION(For local use only) 43B It.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ®1. MOTOR VEHICLE FUEL ®1a. REGULAR UNLEADED [12. LEADED ❑5. JET FUEL (If marked complete Petroleum Type) 01b. PREMIUMUNLEADED 03. DIESEL ❑6. AVIATION FUEL [12. NON-FUEL PETROLEUM ❑1c. MIDGRADE UNLEADED [14. GASOHOL ❑99.OTHER El 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) 442 [:14. HAZARDOUS WASTE (Includes Used Oil) [195.UNKNOWN ' III. TANK CONSTRUCTION ' TYPE OF TANK ❑1. SINGLE WALL ❑3.SINGLE WALL WITH ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [195. UNKNOWN E92. DOUBLE WALL [14. SIGNLE WALL IN VAULT ❑99. OTHER TANK MATERIAL-primary tank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE [195. UNKNOWN 444 (Check one item only) ❑2. STAINLESS STEEL ®4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/ [:199.OTHER REINFORCED PLASTIC(FRP) 100%METHANOL TANK MATERIAL-secordaytank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE [195. UNKNOWN 445 (Check one item only) [12. STAINLESS STEEL 0 4.STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE [199.OTHER REINFORCED PLASTIC(FRP) W1100%METHANOL [15. CONCRETE ❑10.COATED STEEL TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING [:15.GLASS LINING [195,UNKNOWN 446 DATE INSTALLED 447 ORCOATING ❑2ALKYO LINING ❑4 PHENOLIC LINING 06UNLINED ❑99 OTHER (For local use only) (Check one Item only) 44e DATE INSTALLED 449 OTHER CORROSION ❑1 MANUFACTURED CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER (Check one Item only) ❑2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all ®1 SPILL CONTAINMENT 1988 ❑1 ALARM ❑3 FILL TUBE SHUT OFF VALVE Mat apply) ®2 DROP TUBE 1988 ❑2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE 1988 IV.TANK LEAK DETECTION(A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ®2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING 0 9 OTHER IV.TANK CLOSURE INFORMATION IPERMANENT CLOSURE IN PLACE 455 ESTIMATED QUANTITY OF SUBSTANCE ass as7 ESTIMATED DATE LAST USED(YR/MO/DAY) REMAINING TANK FILLED WITH INERT MATERIAL.? 3/2000 0 gallons ❑Yes ® No UPCF (1/99 revised) Formerly SWRCB Form B