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1 UIVED PROGRAM CONSOLIDATED FORNV ANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 as per tank) Page�,of 5 TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION 1 67TEMPORARY SITE CLOSED RE SITE (Check one Item only) 430 ❑ 3 RENEWALPERMIT (Spedfy reason-for local use only) (Specify reason-for local use only) ® 8 TANK REMOVED i FACILITY ID: BUS NESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Tosco #256981 -Pacific 76 431 LOCATION WITHIN SITE(Optional) South side of site 4707 Pacific Avenue & March Lane,_STOCKTO I.TANK DESCRIPTION (A.scaled plot plan with the location of the UST system Including buildings and landmarks shall be submitted to the local aenc : 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/M0) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1988 12,000 438 ADDITIONAL DESCRIPTION(Forlocal use only) ILsTANKCONTENTS 440 TANK USE 439 PETROLEUM TYPE ®1. MOTOR VEHICLE FUEL 01a. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL (If marked complete Petroleum Type) ❑11b. PREMIUM UNLEADED ❑3. DIESEL ❑6. AVIATION FUEL [12. NON-FUEL PETROLEUM ❑1c. MIDGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER 442 [3 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Wanes inventory page) 441 CAS#(from Hazardous Materials Inventory page) [14. HAZARDOUS WASTE (Includes Used Oil) ❑95 UNKNOWN IIL .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 02. DOUBLE WALL [14. SIGNLE WALL IN VAULT ❑99. OTHER 444 TANK MATERIAL-primary lank ❑1. BARE STEEL [13. FIBERGLASS/PLASTIC ❑5. CONCRETE [3 95. UNKNOWN (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-secontlary tank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE 95. UNKNOWN 445 (Check ane item only) ❑2. STAINLESS STEEL ®4R STEEL CLAD PLASTIC(FRP)LASS ❑ W/100P METHANOL [-199. 99'OTHER ❑5. CONCRETE ❑10.COATED STEEL TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING [15.GLASS LINING [195.UNKNOWN 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING 0 UNLINED ❑99 OTHER (For local use only) (Check one Item only) 448 DATE INSTALLED 449 OTHER CORROSION ❑1 MANUFACTURED CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 4 IMPRESSED CURRENT ❑99 OTHER PROTECTION IF APPLICABLE PROTECTION (For local use only) (Check one item only) ❑2 SACRIFICIAL ANODE 452 SPILLAND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED (Check all ®1 SPILL CONTAINMENT 1988 ❑1 ALARM ❑3 FILL TUBE SHUT OFF VALVE that apply) ®2DROP 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) 454 IF SINGLE WALL TANK(check all that apply) 453 IF DOUBLE WALLTANK OR TANK WITH BLADDER (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 D 7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER Y " ,;IV.aTANKCLOSURE INFORMATION/PERMANENT CLOSUREIN PLACE . ^ 455 457 455 ESTIMATED QUANTITY OF SU35TANCE TANK FILLED WITH INERT MATERIAL? ESTIMATED DATE LAST USED(YR/M( DAY) REMAINING 0 gallons El Yes ® No 3/2000 Formerly SWRCB Form B UPCF (1/99 revised)