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UNIFIED PROGRAM CONSOLIDATED FORM 107 � 7 UNDERGROUND STORAGE TANK ! OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per UST) TYPE OF ACTION tl•l k one item only. For an UST permanent closure or removal,complete only this section and Sections I,II,III,IV,and IX below) 430 ❑ I.NEW PERMIT ISI 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7,UST PERMANENT CLOSURE ON SITE ❑ S.UST REMOVAL DATE UST PERMANENTLY CLOSED: 4J0a DATE EXISTING UST DISCOVERED: ,1306 I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) - _ I BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) Jamar Service 3 BUSI)J�755 E ADDRESS St 101 CITY 44 Stockton 101 II.TANK DESCRIPTION 132 TANK ID# TANK MANUFACTURER 433 TA0508143 Ty�AyyN�K CONFIGURATION: THIS TANK IS 434 Xerxes f_y'r.ASTAND-ALONE TANK ❑2.ONE IN A COMPARTMENTED UNIT. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1998 19000 9 III.TANK USE AND CONTENTS TANK USE 1p la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ Ic.AVIATION FUELING 439 ❑ I.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(rm W.Useq Oil) ❑ 5.EMERGENCY GENERATOR FUEL(HS fn2i L5(e)) ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify):CONTENT$ PETROLEUM: Is.REGULAR UNLEADED ( P fy): 43% I.DIESEL ❑ IJ.MIDGRADE UNLEADED ❑ 1 b.PREMIUM UNLEADED NO ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ B.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM S eci NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL 440s ❑ 11.OTHER NON-PETROLEUMS eci : 9qW IV. TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL 2.DOUBLE WALL ❑ 95.UNKNOWN PRIMARY CONTAINMGNT ❑ I.STEEL 3.HJJERGLASS [I6ANTERNAL BLADDER N3 ❑ ].STEEL+INTERNAL LINING ❑ 95.UNKNOWN 414 SECONDARY CONTAINMENT ❑ I.STEEL ❑ 99,OTHER (S Jif ,1441, �3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 90.NONE ❑ 95.UNKNOWN ❑ JACKETED qq5 OVERFILL PREVENTION 1.AUDmLE k VISUAL ALARMS ❑ OTHER(S ecif): 44Sa ❑ 2.BALL FLOAT 3.FILL TUBESHUT-OFFVALVE qq2 ❑ 4.TANK MEETS REQUIREMENTS FOA EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑ 1.SINGLE-WALLED 50 2.DOUBLE-WALLED ❑99.OTHER SYSTEM TYPE -40 I.PRESSURE ❑ 2.GRAVITY - [13.CONVENTIONAL SUCTION [14.SAFE SUCTION23CCR 42636(1,X3) 438 PRIMARY CONTAINMENT ❑ 1.STEEL 4.FIBERGLASS I El 90.NONE ❑ B.FLEXIBLE ❑ io.RIGID PLASTIC ❑ 95.UNKNOWN 4M ❑ 99.OTHER(Specify): d6ge SECONDARY CONTAINMENT ❑ 1.STEEL IV 4.FIBERGLASS 118.FLEXIBLE [I Wit ONE ❑ 95.UNKNOWN 10.RIGID PLASTIC 46,16 PIPINGr1'URBINECONTAINMENT SUMP TYPE ❑ 99.OTHER(Specify): 469c 1.SINGLE WALL [1 2.DOUBLE WALL ❑ 90.NONE 4 VENT PRIMARY VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION CONTAINMENT IR LSTEEL 4.FIBERGLASS 10.RIGID PLASTICU 90.NONE U 99.OTHERS ( PxifY) 46ge VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ q,FIBERGLASS ❑ 10.RIGID PLASTIC 46641 90.NONE ❑ 99.OTHER(Specify) 469f VR PRI MARY CONTAINMENT W LSTEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER S eci gbgg ( P 9') VR SECONDARY CONTAINMENT ❑ LSTEEL 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE469 r ,� ❑ 99.OTHER(Specify) 4N VENT PIPMGTRANSITION SUMP TYPE LSINGLE WALL 2.DOUBLE WALL 464hI RISER PRIMARY CONTAINMENT ❑ 90.NONE 46gf 1.STEEL 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE RISE99.OTHER(Specify) 4Mj R SECONDARY CONTAINMENT 1.STEEL 4.FIBERC4ASS 10.RIGID PLASTIC 90.NONE469 I ❑ 99.OTHER(Specify) 46,11, FILL COMPONENTS INSTALLED 1.SPILL BUCKET 1.STRIKER PLATFIBOTTOM PROTECTOR 4. 6 ki CONTAINMENT SUMP q VII.ONDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE I.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 1.NO DISPENSERS CONSTRUCTION MATERIAL 1.STEEL q.FIBERGLASS ❑ 90.NONE"`:-[. ,1691, ❑ 10.RIGID PLASTIC ❑ 99.OTHER(S ecify) 469y�. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ��- ❑ 6.ISOLATION - 4qg. IX. APPLICANT SIGNATURE CERTIFICATION: t certify rhea this UST system Is and in full compatible with the hazardous substance stared and that the information provided herein IS true,accurate, com lienee with le air ulrements. APPLICANT SIGNATURE DATE C,- 10/16/2009 4'0' APPLICANT NAME (print) 47. APPLICANT TITLE Ja MCILrath 42. Owner L UPCF UST-B-1/2 Rev.(12/2007)