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IFIED PROGRAM CONSOLIDATED FO TANK: TA0505043 PR#: PRO231459 UNDERGROUND STORAGE TANKS -T��( ` PAGE DI/ FAC#: FA0003677 \4> io A 03 j"` (l.pages per tank) Pavlof, TYPE OF ACTION ❑ I NEW SITE PERMIT ❑ 4 AMENDED PERMIT 5 CHANGE OF INFORMATION ❑ b TEMPORARY SITE CLOSURE (ChmkmNmma Wy) ❑ 7 PERMANENTLY CLOSED ON SUE ISP t ny�n� mcl +I mr.a tyJ tP 9T-�� t Imi wly r-13RENEWAL PERMIT p jp ❑STANK REMOVED uo FACILITY m: PR#: BUSINESS NAME(Su,eu PAC¢IYNAMBm DBA-Oomg Barons As) 1 GAS DEPOT 3 FA0003677 PR0231459 LOCATION WITHIN SITE(apdmm0 824 E YOSEMITE AVE,MANTECA 431 PHONE I.TANK DESCRIPTION(A scaled plot plan with We location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK m# Tank#: 5 432 TANK MA ACTUUR/ER`^ 433 COMPARTMENTALIZED TANK ❑Yes No 434 TA0505043 lU c7 vv R^Yn^,emplae®epag<Foreedicmpw,uv. DATE INS? D(YEAR/MO) 435 TANK CAPACITY INGALLONS 436 NUMBER OF COMPARTMENTS 437 61 Lj 12,000 ADD N DESCRIPTI N(Fmbsa=oay) 438 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® I.MOTOR VEHICLE FUEL ® Is.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Invkdmvrylmc Pcaolmvn Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ b.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADEUNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(bma naaamn m.urisk CAS#(6amna>ammm Mmsna ammamy page) 442 ❑4.HAZARDOUS WASTE (W,aka uvea a0 REGULAR ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM M3 (C6mk mm 0emmly) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 4H (L .iu,nmly) ❑ 2.STAINLESS STEEL ® STEEL CLADW/FIBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER. TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ��❑] 3.FIBERGLASS/PLASTIC C] 5.CONCRETE E]95.UNKNOWN us (Clmtkam mm�mlY) ❑ 2.STAINLESS STEEL yJ 4.STEEL CLAD W/FIBERGLASS C] B S.FRPCOMPTLEW/100%METHANOL ` REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑".OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ I.RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 416 DATE INSTALLED 447 OR COATING (CTmkam itan my) ❑ 2 ALKYD LINING ❑4 PHENOLIC LINING ❑ 6 UNLINED ❑ 99.OTHER (Pm bol aaemty) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 446 DATE INSTALLED M9 PROTECTION IF APPLICABLE PROTECTION (L2ckaeltmnmdy) ❑ 41MPRESSEDCURRENf ❑ 99 OTHER ❑ 2 SACRIFICIAL ANODE (Farbaluaeenly) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(balmemdy) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Om&allshatepply) I SPILL CONTAINMENT ❑ I ALARM 3 FILLTUBE SHUT OFF VAI` 2 DROP TUBE ❑ 2 BALL 4 EXEMPT 3 STRIKER PLATE FLOAT TV.TANK LEAK DETECTION(A a crip&a oneem tm6,ap�andlto smaatm ba.bml agmry.) IF SINGLE WAIL TANK(CR At dmt apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Ourkane ummly) ❑2AUTOMATIC TANK GAUGING(ATG) ❑ bVADOSE ZONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATC ❑ 7GROUNDWATER ®2 CONTINUOUS mnitsmU MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIA.TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 ❑Yes ❑ No UPCF(12/99 revised)