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67MED PROGRAM CONSOLIDATED IVI M ? / UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(one fmm per U TYKE OF ACTION (Check one hem only. Foran UST permanent closure or removal,complete only this section and Sections I,II,III,IV,and IX below) 430 1.NEW PERMTT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430a DATE EXISTING UST DISCOVERED: 906 L FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ _ 1 3 7 3 g 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Tower Mart#886 BUSINESS SITE ADDRESS 103 CITY 104 1434 W.Yosemite Ave. Manteca CA II.TANK DESCRIPTION TANK ID# PU-886 432 TANK MANUFACTURER 433 T ONFIGURATION: TIBS TANK IS 434 Modem Welding 1.A STAND-ALONE TANK n i -T y/� O '((/ 57� ❑2.GNEwACGMFARTE UNrr. /-� ( Y� one pp Itte for nch wmpenmenl the ural. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF,COMPARTMENTS IN THE UNIT 437 Jan 1991 8,000 Gal One 1 III.TANK USE AND CONTENTS TANK USE Ia.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING ❑ Ic.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE( h 1.Ued Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(.)] ❑ 6.OTHER GENRRAT FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 43% CONTENTS PETROLEUM: NOTFIREGULAR UNLEADED ❑ lc.MIDGRADE UNLEADED b.PREMIUM UNLEADED 440 pN ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM 5 440a NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ ILOTHERNON-PETROLEUM 5 i : 44ob IV. TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL .DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT W.STEEL ❑ 3.FIBERGLASS ❑ &INTERNAL BLADDER 444 7.STEEL+INTERNALLINING ❑ 9 .UNKNOWN [199.OTHER (Sped : 444e SECONDARY CONTAINMENT [11.STEEL Ll 3.FIBERGLASS 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 445a OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT UpfFILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUC /WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑1 SINGLE-WALLED .DOUBLE-WALLED ❑99.OTHER 450 SYSTEM TYPE 1.PRESSURE ❑ 2.GRAVITY [13.CONVENTIONAL SUCTION [14.SAFE SUCTION 23 CCA§2636(aK3)I 458 PRIMARY CONTAINMENT ❑ 1.STEEL Lr4.FIBERGLASS ❑ 8.FLEXIBLE ❑ HL RIGIDPLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specdy): 464a SECONDARY CONTAINMENT ❑ 1.STEEL [DA.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 4646 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 4610 PIPINGn URBINE CONTAINMENT SUMP TYPE 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d VL VENT,VAPO RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT 1.STEEL 4.FIBERGLA55 ❑ 10.RIGID PLA5TIC 90.NONE 99.OTHER(Specify) 469e 464e1 VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464f 46/fl VR PRIMARY CONTAINMENT ar 1.STEEL ❑ 4.FIBERGLASS 0 10.RIGID PLASTIC 90.NONE ❑ 99.OTHER(Specify) 4=181 VR SECONDARY CONTAINMENT ❑ I.STEEL El 4.FIBERGLASS 0 10.RIGIDPLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464h 464h1 VENT PIPING TRANSITION SUMP TYPE ❑ SINGLE ❑ 2.DOUBLE WALL [190.NONE RISER PRIMARY CONTAINMENT ❑ 1.1.STEEL WALL 4.FIBERGLASS ❑ 10.RIGID PLASTIC Li W.NONE LJ 99.O1HER(Specify) 46ai 464'1 RISER SECONDARY CONTAINMENT ❑ L STEEL 0 4.FIBER ASS ❑ 10.RIGIDPLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464k 4 Ikl FILL COMPONENTS INSTALLED W1.SPILL BUCKET Iff 3.STRIKER PLATESOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP 451a< VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE 1.MM DOUBLE 2 UBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469. CONSTRUCTION MATERIAL. ❑ 1.STEEL ❑ 4.FIBERGLASS 10.RIGIDPLASTIC ❑ 99.OTHER S 4696' VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.MPRF_SSED CURRENT ❑ 6.ISOLATION 445. IR. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in full coriiiiiiiance with I uirement& APPLICANT SIGNATURE DATE 3/3/08 °'° APPLICANT NAME(print) Paul Chevalier 411_ APPLICANTTITLE Maintenance Manager 4n. UPCF UST-9-1/2 Rev.(12/2007)