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U ED PROGRAM CONSOLIDATED FORM • TANK: TA0515638 PR #: PRO231595 UNDERGROUND STORAGE TANKS -TANK PAGE i FAC #: FA0003591 (two pages per lank) Pagc 4 of TYPE OF ACTION ❑ (NEW SITE PERMIT ❑ 4AMEIDED PERMIT ❑ S CHANGE OF IN❑ bTEMPORARY SITE CLOSURE �v (Cla hmly isms only.) _. .J �- ❑ 7 PERMANENTLY CLOSED ON SITE fSpccfi rca. far lou Lsc onl.9 lSpx Bmeson-[rla<alnwovh) ❑STANK REMOVED 430 ❑ 3RENEWAL PERMIT BUSINESS NAME(Same as FACILITY NAME m DBA -Wing Busimsa Uzi 1'AC11]IY IDI PRS I LINDEN MARKET FA0003591 PRO 31595 LOCATION WITHIN SITE (opt m) 8203 E RWY 26, STOCKTON 431 PHONE I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submined to the local agency.) TANK ID# Tank N: 5 432 TANK I.AAM7FACTURER 433 COMPARTMENTALIZED TANK ® Yes E] No 434 TA0515638 MODERN WELDING I["Yes-,mmplemmepagefinenhwm,noncct. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1 $ 000 2 ADDITIONAL DESCRIPTION (Fm Inial usc.h') 438 B. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 44o ® 1. MOTOR VEHICLE FUEL ❑ la. REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL (I[mmkW cmnplem Petraluon Type) ® Ib. PREMIUM UNLEADED ❑ 3. DIESEL ❑ 6. AVIATION FUEL ❑ 2. NON -FUEL PETROLEUM ❑ Ic MIDGRADE UNLEADED ❑ 4. GASOHOL ❑ 99. OTHER ❑ 3. CHEMICAL PRODUCT COMMON NAME (from Hvm Matcmis In -m page) 441 CAS# (f n He os ma c als mvmmn page) 442 ❑ 4. HAZARDOUS WASTE 91 GASOLINE 8006-61-9 0Wl susmw) ❑ 95. UNKNOWN BL TANK CONSTRUCTION TYPE OF TANK ❑ I. SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 EXTERIOR MEMBRANE LINER ED 95 UNKNOWN (Chukam nen ody) ® 2. DOUBLE WALL ❑ 4. SINGLE WALL IN VAULT ❑ 99. OTHER TANK MATERIAL -primary tank ❑ I. BARE STEEL ❑ FIBERGLASS/ PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN 444 (Cnkmmi.Wy) ❑ 2. STAINLESS STEEL IM STEEL CLAD WMBERGLASS ❑ 8. FRP COMPTIBLE W/ 100% METHANOL REINFORCED PLASTIC (FRP) ❑ 99. OTHER TANK MATERIAL -secondary tank I. BARE STEEL R . FIBERGLASS/ PLASTIC E] 5. CONCRETE E] 95. UNKNOWN 445 (CIsA one imm only) ❑ 2. STAINLESS STEEL ®4. STEEL CLAD W/FIBERGLASS ❑ 8. FRP COMPTIBLE W/100'6 METHANOL REINFORCED PLASTIC (FRP) ❑ 10. COATED STEEL ❑ 99. OTHER ❑ 5. CONCRETE 447 TANK INTERIOR LINING ❑ I. RUBBER LINED ❑ 3. EPDXY LINING ❑ 5. GLASS LINING ❑ 95. UNKNOWN 446 DATE INSTALLED ORCOATING ❑ 99. OTHER (CIsA meimn.ty) F12ALKYDLINING ❑ 4PHENOLIC LINING ®6 UNLINED (Fmlmalum-s) 49 OTHER CORROSION ❑IMANUFACTURING CATHODIC ❑3FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION ❑ 41MPRESSED CURRENT ❑ 99 OTHER (CM1sk.,imm.ly) ❑ 2SACRIFICIAL ANODE (Fmlac I..ly) SPILL AND OVERFILL YEAR INSTALLE850 TYPE(lmalusemly) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 M I SPILL CONTAINMENT 2,002.00 PHILTITE M 1 ALARM 2,002.00 ❑ 3 FILL TUBE SHUT OFF VAL` (Ch J: all Neupply) ❑R 2 DROP TUBE 2,002.00 OPW ® 2 BALL 2,002.00 ❑ 4 EXEMPT ❑X 3 STRIKER PLATE 2,002.00 LINK FLOAT IV. TANK LEAK DETECTION (A acamgim nra„ mmit.�ng p�a�^ an.11 x mmnnmd moon loeal.geuy.) IF SINGLE WALL TANK(Ckcknll Wt apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Cloak.,item only) F1 1 VISUAL (EXPOSED PORTION ONLY) E] S MANUAL TANK GAUGING(MTG) E] I VISUAL (SINGLE WALL IN VAULT ONLY) ❑ 2 AUTOMATIC TANK GAUGING (ATG) ❑ 6 VADOSE ZONE ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ® 2 CONTINUOUS INTERSTITIAL MONITORING ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK TESTING ❑ 3 MANUAL MONITORING (SIR) BIENNIAL TANK TESTING ❑ 990THER V. TANK CLOSURE INFORMATION/ PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE RENAMING 456 TANK FILLED WITH INERT MATERIAL? 49 ❑ Yes ® No UPCF (12/99 revised)