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FIED PROGRAM CONSOLIDATED FORM D-) ANK: TA0505680 f1 � PRH: PRO231227 UNDERGROUND STORAGE TANKS -TANK PAGE 1 Wy FAC H: F (two pages perr tank) 33 tank) I2 e4 f TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑4 AMENDED PERMIT ❑5 CHANGE OF INFORMATION ❑ 6 TE�kNCNTQ#VE�A LOSU0(Cheek Wy iam ally) J8i q'I'� ❑ 7PEA l( ❑8 TANK REMOVED 430 F-13 RENEWAL PERMIT FACILITY ID: PR#: BUSINESS NAND:(Saa<m FACILITY NAME«DBA-Doing Bminms As) 3 PR0231227 CIRCLE K STORES INC#2705449* FA0004033 431 LOCATION WITHIN SITE(00.1) 7647 PACIFIC AVE,STOCKTON PHONE L TANK DESCRIPTION(A scaled plot plan wish the location ofthe UST system Including buildings and landmarks shall he submi0ed to the local agency.) TANK ID# Tank#: 6 432 TANI"�ANUFACTURER 433 COMPARTMENTALIZED TANK E]Yes ❑No a3a TA0505680 XERXES If^Yaacomplete o«pager«mob ramparmamt. DATE INSTALLED(YEAR/MO) 43s TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 5/22/1995 12:00:OOAM 12,000 439 ADDITIONAL DESCRIPTION(F«lams«easy) EL TANK CONTENTS TANK USE 439 . PETROLEUM TYPE 040 ® 1.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Ifmmkd compinc P.I.Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ® Ic.MIDGRADEUNLEADED ❑4.GASOHOL ❑WOTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(rsmn Hvndau Maeia6 mvcm«y page) 4q1 CAS#(from Harudwu Meeials mraamrvpage) 442 ❑4.HAZARDOUS WASTE (lacldm Usd Oil) ❑ 95 UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE MHM WITH LINER ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Cheekaaeieaoaly) EXTER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ 99.OTHER L BARE STEEL ® FIBERGLASS/PLASTIC E] 5, ❑ 95.UNKNOWN 44 TANKMATERIAL-primary tank F-1 (Cheekaan itmn wy) ❑2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100'/.METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER 1.BARE STEEL ® 3.FIBERGLASS/PLASTIC El 5,CONCRETE C:195.UNKNOWN M5 TANKMATERIAL-secondary tank ❑ (Cheek om imm 0*) ❑ 2.STAINLESS STEEL ❑REINFORCED PLAEEL CLAD STIC R _(FRP) ❑ 10 COATED STEEL W/1 ❑ 99.OTHER ❑ 5.CONCRETE 449 TANK INTERIOR LINING ❑ L RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 445 DATE INSTALLED OR COATING ❑99.OTHER (Cheek meitan only) r-12ALKYD LINING ❑ 4PHENOLIC LINING ® 6UNLINED (F«I«al um pwy) 449 OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC M 3 FIBERGLASS REINFORCEDPLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION [:14 IMPRESSED CURRENT ❑ 99 OTHER (Cn amimm°nly) E] 2 SACRIFICIAL ANODE (F«I«elau oM,) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(loeelue only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (cleekell mateppy) ® I SPILL CONTAINMENT 1,995.00 ❑ IALARM ®3 FILL TUBE SHUT OFF VAL' 1,995.00 X❑ 2 DROP TUBE 1,995.00 ❑ 2 BALL ❑ 4 EXEMPT Q 3STRIKER PLATE 1,995.00 FLOAT IV.TANK LEAK DETECTION(A4mmipumacmemaaitmgpmgramshallxsubmitmdmmeleeafaaerey.) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 IF SINGLE WALL TANK(Cheek all mat apply) (Check a«itan cry) ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑3CONTINUOUS ATG ❑ 7GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK TESTING ❑ 3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL' 457 ❑Yes [-] No UPCF(12/99 revised)