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- �rL F/DV�I1�L,4f � W UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION (One lonn m use TYPE OF ACTION (Check one item only For a UST clanne or removal,complete only this section and Sections 1,11,LU IV,and LYbelow) 430. ® L NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION 6.TEMPORARY UST CLOSURE Ej 7.UST PERMANENT CLOSURE ON SITE 0 S.UST REMOVAL DATE UST PERMANENTLY CLOSED: 43R 1 DATE EXISTING UST DISCOVERED: 4306 I. FACILITY INFORMATION FACILITY ID#(Agerry Use Only) _ 1 1 1-10 1 7 8 1 9 1, BUSINESS NAME(Some as Facility Name or DBA-Doing Business As) 3, GASSPECS, INC. dba GREAT AMERICAN GAS & CAR WASH BUSINESS SITE ADDRESS 103. CITY 101. 2115 W. Yosemite Ave. Manteca II. TANK DESCRIPTION TANK ID# 432 TANK MANUFACTURER 433, TANK CONFIGURATION:THIS TANK IS 434. 3 COJIIBItunent Solutions I C9 Q I.ASTAND-ALONE TANK Caowl .~fo,e 2.ONE INA COMPARTMENTED UNIT muew DATE UST SYSTEM INSTALLED435. TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS IN THE UNIT 437, 2007/12 10,000 2 III. TANK USE AND CONTENTS TANK USE ® Ia MOTOR VEHICLE FUELING Q Ib.MARINA FUELING ❑ lc.AVIATION FUELING 439. ❑ 3.CHEMICAL PRODUCT STORAGE Q 4.HAZARDOUS WASTE(lecludn usw oil) ❑ 5.EMERGENCY GENERATOR FUEL p6C 525281.5(.)) Q 6.OTHERGENERATOR FUEL _ ❑ 95.UNKNOWN _ ❑ 99.OTHER SpecifyX 4394 EN CONTTS PETROLEUM: Q Is.REGULAR UNLEADED ❑ 1..MIDGRZE UNLEADED ❑ Ib.PRO41UM UNLEADED MA ® 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS __ Cl 8.PETROLEUM BLEND FUEL _Vt.OTHER PETROLEUM(Sped : 4/h NON-PETROLEUM:Q 7.USED OIL �I Ip,E'FHgNOL ❑ 11.OTHER ION-PETROLEUMS i : 4406 IV. TANK CONSTRUCTION TYPE OF TANK Q I.SINGLE_WALL 0 2.DOUBLE WALL ❑ 95.UNKNOWN a). PRIMARY CONTAINMENT Q L STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 414 _ _ Q 7.STEEL MT_E_R_N_AL LINWG__ __ Q 95.UNKNOWN_ Q 99_OTHER(Specify): 404 SECONDARY CONTAINMENT Q 1.STEEL d FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER Q 90.NONE_ 13 95.UNKNOWN ❑ ].JACKE7® 415. OVERFILL PREVENTION ❑99_OTIIBR(Specify); MS ❑ L AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOA7 ® 3.FILL TUBE SHUT-OFF VALVE 452 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑ L SINGLE WALL ® 2.DOUBLE WALL ❑ 99.OTHER 460 _SYSTEM TYPE _ ® 1.PRESSURE Q 2.GRAVITY___ . O,_3.CONVENTIONAL SUCTION -Q 4_SAFE SUCTION I2)CCR 62636(�x3A 458. PRIMARY CONTAINMENT Q 1.STEEL ® 4.FIBERGLASS 0 8.FLEXIBLE ❑ lo.RIGID PLASTIC 464 _ ❑ 90 NONE ❑ 95.UNKNOWN Q 99.onlER(s 464 SECONDARY CONTAINMENT Q 1.STEEL IM 4.FIBERGLASS ❑ 8.FLEXIBLE Q 10.RIGIDPLASTIC 4616 ❑ 90.NONE ❑ 95.UNKNOWN._.__...._d..9:OTHER(Spify): 464 ...................._. ❑ 90.NONE 461d. PIPING/1'URBINE CONTAINMENT SUMP TYPE 1.SINGLE WALL ® 2.DOUBLE WALL VI. VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS Q 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.GTHER(Speeifyy. 4641. VENT SECONDARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC Q 90.NONE Q 99.OTHER(Specify): 464 464Fl VR PRIMARY CONTAINMENT ❑ i.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC Q 90.NONE Q 99.OTHER(Specify): 4649 VR SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC Q 9o.NONE Q 99.OTHER(Specify): 46 h VENT PIPING TRANSITION SUMP TYPE Q 1.SINGLE WALL ® 2.DOUBLE WALL Q 90.NONE 460i RISER PRIMARY CONTAINMENT ® 1.STEEL Q 4.FIBERGLASS Q 10.RIGID PLASTIC Q 90.NONE Q 99.OTHER(Specify): 4=i RISER SECONDARY CONTAINMENT ❑ 1.STEEL _® 4.FIBERGLASS Q I0.RIGID PLASTIC Q 90.NONE Q 99.OTHER(Spedfy): 4 a FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET Q 3.STRIKER PLATE/BOTTOM PROTECTOR ® C CONTAINMENT SUMP 451. VII. UNDER DISPENSER CONTAINMENT (UDC) CONSTRUCTION TYPE_ _ ❑ 1.sINOLE wALL _ _0 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.A47Z CONSTRUCTION MATERIAL Q 1.STEEL ® 4 FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(SpecVIII. CORROSION PROTECTIONS77:EL COMPONENT PROTECTION ❑ 2.SACRI+ICIAL ANDD s) ❑ 4.thBMeessED CURRENT ® 6.ISOLATIONIX. APPLICANT SIGNATURECERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information proviaccurate,and in full enm luoce with 1 al r uirements. APPLICANT SIGNATURE DATB APPLICANTNAME(Print) SYED K. ARMED 4'1. APPLICANTTITLE Vice President