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UNIFIED PROGRAM CONSOLIDATED FORA? ` TANK: TA0508143 <br /> 0 PR#: PR0231667 <br /> n UNDEAOUND STORAGE TANKS -TA PAGE 1 �?�\O FAC#: FA0002121 <br /> R Y P--") <br /> 5 C� (two pages per tank) <br /> d'• Page 2 of 5 <br /> TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑6 TEMPORARY SITE CLOSURE <br /> w (Cbeh mylw-mJY) ❑ 7 PERMANENTLY CLOSED ON SITE <br /> ❑ 3RENEWAL PERMIT [18 TANK REMOVED 430 <br /> BUSINESS NAME(Sanm v FACILITY NAME m _:_';': FACR.ITY ID: PR#: I <br /> JAMAR SERVICE 1 A0002121 PR0231667 <br /> LOCATION WITIl N SITE(opnoo.) 4075 E MARY ST,STOCKTON 431 <br /> PHONE <br /> 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) <br /> TANK ID# Tank#: 6 112 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK es ❑No 434 <br /> TA0508143 XERXES I lm.",amp .Pagef« ahosa mmn <br /> DATE AISTALLED(YEAR/MO) 415 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 <br /> 10/1/1998 <br /> ADDITIONAL DESCRIPTION(Farloosl mccny) 438 <br /> D.TANK CONTENTS <br /> TANK USE 4J9 PETROLEUM TYPE 440 <br /> p-. <br /> TOR VEHICLE FUEL i�RUNLEADED ❑ 2.LEADED ❑ 5.JET FUEL <br /> (Imtkd mnPlar Patrolemn T3pc) ❑ Its.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL <br /> ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER <br /> ❑ 3.CHEMICAL PRODUCT COMMON NAME(wnlSuaNae M--b ta, t paac) Ml CAS#(ftmn Haurdae Matoin,lnvmwy page) 442 <br /> ❑4.HAZARDOUS WASTE <br /> (MJ UaadaO <br /> ❑ 95.UNKNOWN <br /> ID.TANK CONSTRUCTION <br /> TYPE OF TANK ❑ I.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 <br /> ( ) EXTERIOR MEMBRANE LINER [:195.UNKNOWN <br /> am4as c WALL ❑ 4.SINGLE WALL IN VAULT ❑99.OTHER <br /> TANK MATERIAL-primary tank ❑ Ii� .BARE STEEL 4§jNMkjNN0jM0WWSTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 <br /> (Chvkomimmway) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL <br /> REINFORCED PLASTIC(FRP) ❑ 99.OTHER <br /> TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 <br /> (C one icmnaay) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL <br /> REINFORCED PLASTIC(PRP) ❑ 10.COATED STEEL ❑".OTHER <br /> ❑ 5.CONCRETE <br /> TANK INTERIOR LINING ❑ I.RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING El 95.UNKNOWN 446 DATEINSTALLED H7 <br /> OR COATING <br /> (C6ackn,fuxa0 y) ❑2ALKYD LINING ❑ 4PHENOLIC LINING �'ED ❑ 99.OlTBR (Forloadum.anb) <br /> OTHER CORROSION ❑ I MANUFACTURING CATHODIC ® 3FBERGLA9MONDRCED PLASTIC ❑ 95 UNKNOWN 448 DATEINSTALLED a49 <br /> PROTECTION IF APPLICABLE PROTECTION <br /> �,��) 41MPRESSED CURRENT E] 99OTHER <br /> ( Y ❑ 2SACRIFICIAL ANODE (FQ kval mc6Ny) <br /> SPILLANDOVERFILL YEAR INSTALLE450 TYPEOcalmc®ly) 451 OVERFLLL PROTECTION EQUIPMENT:YEAR INSTALLED 452 <br /> (Chale all not apply) ❑ I SPILL CONTAINMENT 1,998.00 ❑ IALARM ❑ 3 FILL TUBE SHUT OFF VAL` <br /> ❑ 2 DROP TUBE ❑ 2 BALL ❑ 4 EXEMPT <br /> ❑ 3STRIKER PLATE FLOAT <br /> 0 Iv.TANK LEAK DETECTION(A kaod nas.fdmt Wrftaepo,nmnshall beauhvitmdto ts,kasl.aasey.) <br /> IF SINGLE WALL TANK(C all sw,appy) 453 I DOUBLE WALL TANK OR TANK WITH BLADDER 454 <br /> ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (C ammmw) <br /> ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSEZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑ 3CONTIN000S ATG ❑ 7GROUNDWATER ,2„ JpNltoUS INTERSTITIAL MONITORING <br /> ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING <br /> (SB)BIENNIAL TANK TESTING ❑ 99 OTHER <br /> V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 <br /> 10/1/1998 0.00 gallons ❑Yes ❑ No <br /> UPCF(12/99 revised) <br />