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IFIED PROGRAM CONSOLIDATED FOpNw TANK: 0113 1dv l� PRN: PRPR0231231173 UNDERGROUND STORAGE TANK AN PGE 1 FAC#: FA0006423 JN t2I/ttwo pages per tank) �r Page 4 of 7 TYPE OF ACTION F1 NEW SITE PERMIT El AMENDED PERMIT UU 5 CHANGE OF INFORMATION ❑6 TEMPORARY SITE CLOSURE (Ch onyitan only) (((�" [37 PERMANENTLY CLOSED ON SITE (Sp y- fnlo®--Y) (Spaiyicuan-forbml ueemlyj ❑&TANK REMOVED 430 ❑ 3RENEWAL PERMIT 1 FACILITY ID: PR#: BUSINESS NAME(sameae FACarn'NAhEw DBA-Daingaisa As inm ) 3 pR0231173 UNITED GAS FA0006423 431 LOCATION WITHIN SITE(opti000) 3440 E MAIN ST,STOCKTON PHONE I.TANK DESCRIPTION(A waled plat plan with the location of the UST system including buildings orallandmarks sball be submitted 0 the local agemy.) TANK IDN Tank#: 5 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yea ❑No 434 TA0504863 TRX SCO0"Y'"".`°�+paap'"°�a' DATE INSTALLED(YFAR/M0) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 431 10/21/1993 12.00:OOAM 10,000 438 ADDITIONAL DESCRIPTION(Forloral meomy) H.TANK CONTENTS 440 TANK USE 439 PETROLEUM TYPE 5.YET FUEL ® I.MOTOR VEHICLE FUEL ❑J I a.REGULAR UNLEADED F1 2.LEADED ❑ Ofmukd compkae Pabolevn TYPe) 4� Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM le.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(6wn HvaNao Mataial+bmmtay page) "I CAS#(Som Hawdoa+Mateials lnvmtm page) 442 ❑4.HAZARDOUS WASTE (b a&a useso0) ❑ 95.UNKNOWN IH.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑ 3.SINGLE WALL WITH EXTERIOR MEMBRANE LINER I-] 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 43 ❑95.UNKNOWN (Ch koneitemanlYl ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT E]99.OTHER TANK MATERIA.-primary tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (C6ak.itvn only) ❑2.STAINLESS STEEL ® STEEL CLAD W/FTBERGLASS ❑ g.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary taek ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 El S.FRP COMPTIBLE (Chskomitananly) ❑ 2.STAINLESS STEEL ®4.STEEL CLAD REINFORCED PLASTIC F(FRP) S ❑ 10.COA EDSEELW/1❑99.%OTHER ❑ 5.CONCRETE 4a7 TANK INTERIOR LINING ❑ L RUBBER LINED ❑3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 99.OTFIER OR COATING (ChNtme aen may) ❑2 ALKYD LINING F-14 PHENOLIC LINING 6UNLINED (Fm Io use oalY) d49 FOTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN "a DATE INSTALLED CTION IF APPLICABLE PROTECTION ❑4IMPRESSED CURRENT ❑99 OTHER (Falmlu+emaY) nci.wy) ❑2 SACRIFICIAL ANODE AND OVERFILLYEAR INSTALLE150 TYPE(Iecalme my) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED452 1 SPILL CONTAINMENT ) �{ag93A03 ❑ 1ALARM ® 3 FILL TUBE SHUT OFF V,t 1 VI thm appy) ]� 4 EXEMPT ❑X 2 DROP TUBE },99}.00 � �,J ❑ FLOAT ❑ ❑ 3STRIKER PLATE N.TANK LEAK DETECTION(A dmaiptioeoftlrcmmitaringpto®en�sMO besubmiudto the)pal agepryJ 453 IF DOUBLE WALL TANK ORTANKWITH BLADDER 454 IF SINGLE WALL TANK(Cbak ill that apply) (Ch ono temmly) ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK TESTING ❑3 MANUAL MON'TOM NG (SIR)BIENNIAL TANK TESTING ❑99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 ESTIMATED DATE LAST USED(YR/MO/DAY) ❑Yea ❑No UPCF(12/99 revised)