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UyFIED PROGRAM CONSOLIDATED FOR11.
<br /> UNDERGROUNDSTORAGETANK
<br /> OPERATING PERMIT APPLICATION-TANK INFORMATION (One form per UST)
<br /> TYPE OF ACTION (Check ane item only For a UST closure or removal,complete only this section and Sections),II,ID IP,and IX below) 430'
<br /> Cl 1.NEW PERMIT 0 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION
<br /> 0 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ATB EXISTING UST DISCOVERED:S.LIST REMOVAL 43
<br /> DATE UST PERMANENTLY CLOSED:
<br /> s re s. .�. X ny+* , �• r`51 i,.-,r, -z. 5� "Y � r��
<br /> 'S,.�nwxsr .:.3?i'r,.trv5�,. ,:.'tn`';�v; �n �°�. L. m .r,. uw
<br /> FACILITY ID#(Agency Urn Only)
<br /> BUSINESS NAME(Same as Facility Name or DBA-Doing BwhwjsAs) 7.
<br /> MCI, doing business as, Verizon Business
<br /> BUSINESS SITE ADDRESS los" CITY 104.
<br /> 2500 W Turner Road S Lodi
<br /> kpY,;,hAd "k+'"'4 440,/2.,fi A E r ^ fir f(►}�}C'�',eY� a(T P ' y�Y '��3�st,2� k S� 's
<br /> Y3v 'k t<.x,..i.LnMix.-�°'a :r. A.x. i -="4N.'
<br /> TANKED# �- TANKMANUFACTURER 63% TAN
<br /> TANK THIS TANK IS
<br /> 0 1.A STAND-ALONE TANK Ccepbteom,Wfbreuh
<br /> I Owens Coming 0 2.ONEINA COMPARTMENTEDUNn Dman a4le .ft.
<br /> DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS IN THE UNIT 437.
<br /> April 1991 4,000 1
<br /> ": M?
<br /> . : . SII.:F ? USEh., 9 ,,N PS ' . „ .
<br /> TANKUSE 0 1a.MOTORVEHICLEFUELING 0 It.MARINA FUELING 0 Ic.AVIATION FUELING 4J9 .
<br /> 0 3.CHEMICAL PRODUCT STORAGE 0 4.HAZARDOUS WASTE(I.W.U�d OiD 0 5.EMERGENCY GENERATOR FUEL[RSC§25281.X01
<br /> O 6.OTHER GENERATOR FUEL 0 95.UNKNOWN _ O 99.OTHER Speeify): 439i
<br /> CONTENTS PETROLEUM: 0 Is.REGULAR UNLEADED 0 lc-MIDGRADE UNLEADED 0 Ib,PREMIUM UNLEADED 440'
<br /> 0 3.DIESEL 0 5.YET FUEL 0 6.AVIATION GAS
<br /> 0 8.PETROLEUM BLEND FUEL 0 9.OTFIlRt PETROLEUM(Specify): 4400
<br /> NON-PETROLEUM 0 7.USED OIL ]0.EniANOL
<br /> 0 11.OTHER NON-PETROLEUM IS 4406'
<br /> . N I./�v, 59'-LF
<br /> N15.trT. .c Wire,Sr .k. .., n15.
<br /> TYPE OF TANK O 1.SINGLE WALL 0 2.DOUBLE WALL 0 95.UNKNOWN 443.
<br /> PRIMARY CONTAINMENT 0 1.STEEL 0 3.FEBERGLASS 0 6.INTERNAL BLADDER 444.
<br /> 0 7.STEEL+INTERNAL LINING 0 95.UNKNOWN CO 99.OTHER(Specify):
<br /> 4440
<br /> SECONDARY CONTAINMENT 0 1.STEEL ®3.FIBERGLASS 0 6.EXTERIOR MEMBRANE LINER 0 7,IACKErED H5.
<br /> O 90.NONE 0 95.UNKNOWN 0 99.OTHER(Specify). . 44k
<br /> OVERFILL PREVENTION 0 L AUDIBLE&VISUAL ALARMS 0 2.BALL FLOAT 0 3.FILL TUBE SHUT-OFF VALVE 452
<br /> 4 U
<br /> TANK MEETS AE UIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION E QUIPMENT
<br /> S
<br /> -'t`
<br /> PIPING CONSTRUCTION O 1.SINGLE WALL 0 2.DOUBLE WALL 0 99.OTHER - - 460.
<br /> SYSTEM TYPE 0 1.PRESSURE 0 2.GRAVITY 0 3.CONVENTIONAL SUCTION 0 4.SAFE SUCTION(23 CCR 1206(,X3)] 458.
<br /> PRIMARY CONTAINMENT 0 1.STEEL 0 4.FIBERGLASS 0 &FLEXBLE 0 10.RIGID PLASTIC 463.
<br /> 0 90.NONE 0 95.UNKNOWN 0 99.OTHER(Sp"*: 4444
<br /> SECONDARY CONTAINMENT 0 I.STEEL 0 4.FBERGtASS ® S.FLEXIBLE 0 [o.RIGID PLASTIC 4Ud
<br /> 0 90.NONE 0 95.UNKNOWN 0 99.OTHER S ): 4
<br /> PIPINGITURBINE CONTAINMENT SUMP TYPE 0 1.SINGLE WALL ® 2.DOUBLE WALL 0 90.NONE
<br /> �•�.<
<br /> VENT PRIMARY CONTAINMENT 0 I.STEEL 0 4.FIBERGLASS 0 10.RIGIDPLASTIC 0 90.NONE 0.99.OTHER(Specify): -
<br /> VENT SECONDARY CONTAINMENT 0 LSTEEL. 0 4.FIBERGLASS 0 10.RIGIDPLASTIC M 90.NONE 0 99.OTIEK(Spec .. 46ar.
<br /> 461fl.
<br /> VR PRIMARY CONTAINMENT 0 1.STEEL. 0 4.FIBERGLASS 0 IO.Rl®PLASTIC -0 90.NONE 0 0 [30 99.OnBR(Spmify): 464q
<br /> VR SECONDARY CONTAINMENT 0 I.STEEL. 4.FIBERGLASS I0.RIGIDPLASnC 0 9D.NONE 99.07EER(Speeify): 464nI.
<br /> VENT PIPING TRANSITION SUMP TYPE O 1.SINGLE WALL 0 2,DOUBLE WAIL 0 90.NONE a61t
<br /> RISER PRIMARY CONTAINMENT 0 1.STEEL [9 4.FIBERGLASS 0 10.RIGIDPLASTIC 0 90.NONE I] 99.OTHER(Specify): 446�
<br /> RISER SECONDARY CONTAINMENT O I.SITE. 0 4.FIBERGLASS O 10.RIGIDPLASTIC 0 90.NONE 0 99.OTFER(Specify): H'
<br /> 444hr.
<br /> FILL COMPONENTS INSTALLED 0 1.SPILL BUCKET O 3.STRIKER PLATEIROTTOM PROTECTOR 0 4.CONTA@14ENT SUMP 4 Leo
<br /> ... ;r{-,a,:3 aa"3'.ikYP s7.:,;>v+,)-"%>�� �.�W'�iL'SL ,!ITlI� ',".•,� CUNTA NT3° ��YL'+ ;r',s ar� M6
<br /> CONSTRUCTION TYPE 0 1.SINGLE WALL 0 2.DOUBIE WALL 0 3.NO DISPENSERS 0 90.NONE 469.
<br /> CONSTRUCTION MATERIAL O L STEEL 0 4.FIBERGLASS 0 10.RIGID PLASTIC 0 99.OTHER(Specify) 469c
<br /> N�3 { S WC�. :✓IV3l'iCTTVL��S743` `(45Y',' - � SKu.aa ~ �S'_:.
<br /> -� s,r� T-,-..4., <,......y r.,.. .. ».� ....,..�.... nG=�s 3� a" 7 ...cr. Yi1.�'i-sw
<br /> STEEL COMPONENT PROTECTION Q 2.SACRIFICIAL ANDD S 0 4.IMPRESSED CURRENT 0 6.ISOLATION 440'
<br /> it _,e av .,r. v° . Y.!>eynu2,ra,eb`'naS- V`Y',:>44, s` A...xS`w .A"'i "� td ir7' •1 Y,�im "-ASt_�
<br /> CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,
<br /> accurateand in full nom sect with Festal re uirement&
<br /> APPLICANT SIGNATUREDATE 5�3/20I0 470.
<br /> APPLICANT NAME(print) Todd Harris 'tL APPLICANTTITLE Regional Environmental Manager 4n
<br /> UPCF UST-B Rev.(12/2007)-V2 www..aidomorg
<br />
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