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Un ED PROGRAM CONSOLIDATED I � TANKS UNDERGROUND STORAGE TANKS -TANK PAGE 1 (two pages per tank) Page P of TYPE OF ACTIONr 1. NEW SITE PERMIT r 4. AMENDED PERMIT X 5. CHANGE OF INFORMATION) r 6. TEMPORARY SITE CLOSURE p (Check one item only) r 3. RENEWAL PERMIT (Specify reason-for Iota/use on/y) _New Format Request r 7. PERMANENTLY CLOSED ON SITE 1 r ( D BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As)3 (Specify change-for local use only) 8. TANK REMOVED 430 1>ID# 99 Shell 1 LOCATION WITHIN SITE(Optional)431 7700 Moreland Court, Stockton, CA 95212 1 TANK ID# I.TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) .-14 a 1-61 ti O?432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK r Yes X No 136146-Waste Oil 5 Owens Corning If AYes=,complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS • 1989 550 One ADDITIONAL DESCRIPTION(For local use only) 438 11.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 0 r I. MOTOR VEHICLE FUEL IF 1a. REGULAR UNLEADED r 2. LEADED r 5. JET FUEL ,N (If marked,complete Petroleum Type) r 1b. PREMIUM UNLEADED r 3. DIESEL r 6. AVIATION FUEL CHEMICAL r 1\J) r 2. L PETROLEUM r 1c. MIDGRADE UNLEADED 4. GASOHOL r 3. CHEMICAL PRODUCT - r� OTHER X 4. HAZARDOUS WASTE(Includes COMMON NAME(from Hazardous Materials Inventory page)441 CAS#(from Hazardous Materials Inventory page) Used Oil) USED OIL F 95. UNKNOWN .III.TANK CONSTRUCTION TYPE OF TANK r I. SINGLE WALL r 3. SINGLE WALL WITH r 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) X2. DOUBLE WALL EXTERIOR MEMBRANE LINER r 95. UNKNOWN r 4. SINGLE WALL IN A VAULT r99. OTHER TANK MATERIAL-primary tank r 1. BARE STEEL X 3. FIBERGLASS/PLASTIC r 5. CONCRETE r 95. UNKNOWN 444 (Check one item only) r 2. STAINLESS STEEL r 4. STEEL CLAD W/FIBERGLASS r 8. FRP COMPATIBLE W/100%METHANOL r 99. OTHER REINFORCED PLASTIC FRP TANK MATERIAL-secondary r 1. BARE STEEL X 3. FIBERGLASS/PLASTIC r 8. FRP COMPATIBLE W/100%METHANOL [ 95. UNKNOWN 445 tank r 2. STAINLESS STEEL r 4. STEEL CLAD W/FIBERGLASS r 9. FRP NON-CORRODIBLE JACKET r 99. OTHER (Check one item only) REINFORCED PLASTIC(FRP) F 10. COATED STEEL r 5. CONCRETE TANK INTERIOR LINING r 1. RUBBER LINED r 3. EPDXY LINING r 5. GLASS LINING r 95. UNKNOWN446 DATE INSTALLED 447 OR COATING Check one item only) r 2. ALKYD LINING r 4. PHENOLIC LINING X 6. UNLINED r99. OTHER For local use only) OTHER CORROSION r 1. MANUFACTURED X 3. FIBERGLASS REINFORCED PLASTIC r 95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE CATHODIC ( r 4. IMPRESSED CURRENT r 99. OTHER Check one item only) PROTECTION (For local use only) r 2. SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED TYPE(For local use only)451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 450 (Check all that apply) X 1. SPILL CONTAINMENT_1998 r 1. ALARM r 3. FILL TUBE SHUT OFF VALVE r 2. DROP TUBE X 2. BALL FLOAT r 4. EXEMPT X 3. STRIKER PLATE 1989_ IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the focal agency.) IF SINGLE WALL TANK(Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER(Check one item only): 454 r 1, VISUAL(EXPOSED PORTION ONLY) r 5. MANUAL TANK GAUGING(MTG) r 1. VISUAL(SINGLE WALL IN VAULT ONLY) r 2. AUTOMATIC TANK GAUGING(ATG) r 6. VADOSE ZONE X 2. CONTINUOUS INTERSTITIAL MONITORING r 3. CONTINUOUS ATG r 7. GROUNDWATER r 3. MANUAL MONITORING r 4. STATISTICAL INVENTORY RECONCILIATION(SIR)+ r 8. TANK TESTING BIENNIAL TANK TESTING r 99. OTHER V.TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YRIMO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons r Yes r No 6