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U ED PROGRAM CONSOLIDATED FORNO y, TANKS UNDERGROUND STORAGE TANKS - TANK PAGE '/ pages per tank) Page�of 5 TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION 1 6El 7TEMPORARY SITE CLOSED RE SITE (Check one Item only) El8 TANK REMOVED 43g 3 RENEWAL PERMIT (Specify reason-for local use only) (specifyreason-tor local use only) ® � 1 FACILITOY I 'v 1 7 BUSINESS NAME(Same as FACILITY NAME Or DBA-Doing Business As) 3 ;/ 1 r Tosco#256981 -Pacific 76 431 LOCATION WITHIN SITE(Optional) South side of site 4707 Pacific Avenue 8 March Lane, STOCKTON I.TANKDESCRIPTION (A scaled plot plan with theJocahorrof theUST system Including Yu-11-dings and landmarks shall be submitted to the local a enc . TANK ID# a3z TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ® No 434 Modern Welding Yes complete one page for each compamerit. 2 436 NUMBER OF COMPARTMENTS 437 DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 1988 12,000 438 ADDITIONAL DESCRIPTION(Far local use only) 440 - II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ❑la. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL ®1. MOTOR VEHICLE FUEL 6. AVIATION FUEL (If marked complete Petroleum Type) 01b. PREMIUM UNLEADED [13, DIESEL ❑ ❑2. NON-FUEL PETROLEUM ❑1c. MIDGRADE UNLEADED [14. GASOHOL ❑99.OTHER 442 (33. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materiels Inventory page) 4a1 CAS#(from Hazardous Materials Inventory page) [:14. HAZARDOUS WASTE (Includes Used Oil) ❑95 UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK ❑1. SINGLE WALL 03.EXTER OR MEMBRANE LINER 096,5. SIUNKNOWNLEL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) 02. DOUBLE WALL [34, SIGNLE WALL IN VAULT ❑99. OTHER 95. UNKNOWN 444 TANK MATERIAL-primary tank i. BARE STEEL ❑3. FIBERGLASS I PLASTIC 5. CONCRETE ❑ (Check one Item only) ❑2. STAINLESS STEEL ®4. STEEL CLAD W/FIBERGLASS ❑B. FRP COMPATIBLE W/ ❑99.OTHER REINFORCED PLASTIC(FRP) 100%METHANOL TANK MATERIAL-sendary tank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE [195.95. UNKNOWN 445 wFRP (Check one item only) [12. STAINLESS STEEL ®4.STEEL CLAD W/FIBERGLASS [0]W/100°/,METHANOL BLE 99.OTHER REINFORCED PLASTIC(FRP) ❑5. CONCRETE ❑1o.COATED STEEL DATE INSTALLED 447 TANK INTERIOR LINING [11.RUBBER LINED [13.EPDXY LINING [15.GLASS LINING ❑95.UNKNOWN 446 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99 OTHER (For local use only) (Check one Item only) 446 DATE INSTALLED 449 OTHER CORROSION Ell MANUFACTURED CATHODIC ❑3 IMPRESSED REINFORCED PLASTIC ❑99 OTHER UNKNOWN PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑ (For local use only) (Check one Item only) ❑2 SACRIFICIAL ANODE452 SPILL AND OVERFILL YEAR INSTALLED 459 TYPE(local use only) 451 OVERFILL PROTECTION EOUIPMENT'.YEAR INSTALLED (Check all ®1 SPILL CONTAINMENT 1988 ❑1 ALARM ❑3 FILL TUBE SHUT OFF VALVE that apply) ❑2 BALL FLOAT ❑4 EXEMPT ®2DROP TUBE 1988 ®3 STRIKER PLATE1988 IV.TANK LEAK DETECTION(A description of the momtonng Program,Dhall oe submitlep to the Iwai agency.) 454 as3 IF DOUBLE WALL TANK OR TANK WITH BLADDER IF SINGLE WALL TANK(Check al,that apPIY) (Check one Item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑2 VISUAL(SINGLE I WALL I TIAL MONITORING N VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ® CONTINUOUS MANUAL MONITORING [33 CONTINUOUS ATG El GROUNDWATER CI ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE45N PLACE 45 ''. 455 ESTIMATED QUANTITY OF SUBSTANCE TANK FILLED WITH INERT MATERIAL ESTIMATED DATE LAST USED(YR/MOIDAY) REMAINING 0 gallons ❑Yes ® NO 3/2000 • Formerly SWRCB Form B ,;F (1/99 revised)