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0/ n1A w UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION (011e from pa UST) TYPE OF ACTION (Check one item only. Fora UST cloture or removal,complete only this section and Sections 1,A III,IV,and IX below) 430. 0 NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ S.CHANGE OF INFORMATION 6.TEMPORARY UST CLOSURE 7,UST PERMANENT CLOSURE ON SITE 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430e DATE EXISTING UST DISCOVERED: 4306 I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) 0 11 7 8 1 9 L BUSINESS NAME(Scone as Facility Name or DBA-Doing Business As) 3. GASSPECS, INC. dba GREAT AMERICAN GAS & CAR WASH BUSINESS SITE ADDRESS 103- C1TY IN 2115 W. Yosemite Ave. Manteca II. TANK DESCRIPTION TANK ID N 432 TANK MANUFACTURER 433. TANK CONFIGURATION:THIS TANK IS 434_ a ` Containment ❑ 1.A STAND-ALONE TANK 2 Cit Solutions Ca ry ae ae p s or m h gQ5 Q ® 2.ONE IN A COMPARTMENTED UNIT 9oe4amoan in thews. DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 43T. 2007/12 12,000 2 III. TANK USE AND CONTENTS TANK USE ® 1.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ Ic.AVIATION FUELING 439. ❑ I CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(1seldes Used Od) ❑ 5.EMERGENCY GENERATOR FUEL IHSC[75281.5(c)) _.__ [1 6..OTHER GENERATOR FUEL (7 95.UNKNOWN s 3 _g_99.OTHER CONUTITS PETROLEUM: ❑ Ii REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEADED ® 1b.PREMNM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ S.PETROLEUM BLEND FUEL ❑ 9_OTRER PETROLEUM_(Specify): 440% NON-PETROLEUM:� 7.USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUMS 440A IV. TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 40 PRIMARY CONTAINMENT ❑ 1.STEEL ® 3.FIBERGLASS Cl 6.INTERNAL BLADDER 444 _ ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑_99.OTHER(Specify): 444 SECONDARY CONTAINMENT ❑ 1.STEEL ®3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445. ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): aaA OVERFILL PREVENTION ❑ 1.AUDIBLE&VLSUAL ALARMS ❑ 2.BALL FLOAT ® 3.FILL TUBE SHUT-OFF VALVE 432. ❑ 4.TANK MEETS REQUIRENIENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑ 1.SINGLE WALL R 2.DOUBLE WALL ❑ 99.OTHER _ 450. SYSTEM TYPE ® 1.PRESSURE ❑ 2 GRAVfIY ❑ 3 CONVENTIONAL SUCTION El4 SAFE SUCTION[23 CCR§2535(eX3p 458. .._._ .. __..._ PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLL ASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 454. ❑ 90.NONE 0 95.UNKNOWN ❑ 99.OTHER(Speei�yf): 464 SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 4M6 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Spwify): 4649 PIPING/TURBINE CONTAINMENT SUMP TYPE ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE 45x1 VI. VENT, VAPOR RECOVERY (VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS 1310.RIGID PLASTIC ❑ 90.NONE [399.OTHER(Specify): a6�9e1 _._------._...._.......---------------- --__..........._._._._____ VENT SECONDARY CONTAINMENT ❑ L STEEL IR 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 4�0 VR PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 4549' --------_.---------- 46ak VR SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): a5a6I VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE IM454` RISER PRIMARY CONTAINMENT ® I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE 1399.OTHER 4N j'_ RISER SECONDARY CONTAINMENT ❑ i STEEL ® 4 FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 454kt. FILL COMPONENTS INSTALLED N 1.SPILL BUCKET ® 3.STRIKER PLATEJBOTTOM PROTECTOR IN 4.CONTAINMENT SUMP 451x. VII. UNDER DISPENSER CONTAINMENT (UDC) CONSTRUCTION TYPE ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 455+ CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS ® 10.RIGID PLASTIC ❑ 99.OTHER(Specify) VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ® 6.ISOLATION 448_ IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information Provided berets is true, accurate,and in fall mintifiance with legal requirements. APPLICANT SIGNATURE DATE 47Q APPLICANT NAME(print) SPED K. AIMED 4n. APPLICANT'RTLE Vice President 472,