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Un ED PROGRAM CONSOLIDATED JI TANKS UNDERGROUND STORAGE TANKS -TANK PAGE 1 (two pages per tank) Page of / TYPE OF ACTION r I. NEW SITE PERMIT r 4. AMENDED PERMIT r 5 CHANGE OF INFORMATION) r 6. TEMPORARY SITE CLOSURE (Check one item only)r 2. OPERATOR CHANGE _New Format Request_ r 7. PERMANENTLY CLOSED ON SITE r 3. RENEWAL PERMIT (Specify reason-for local use only) (Specify change-for local use only) r 8. TANr K REMOVED 430 4 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As)3 FACILITY ID# 1 \ 99 Shell, B&C Angle 2i 7 3 LOCATION WITHIN SITE 7700 Moreland Court, Stockton, CA 95212 I.TANK DES RIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# 432 TANK MANUFACTURER 433 X No 34 �/� O l COMPARTMENTALIZED TANK r Yes 136146-Regular Owens Corning If AYes=,complete one page for each com ent. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 7 1989 12,000 NE ADDITIONAL DESCRIPTION(For local use only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 0 X 1. MOTOR VEHICLE FUEL X.1a. REGULAR UNLEADED r 2. LEADED r 5. JET FUEL (If marked,complete Petroleum Type) r 1b. PREMIUM UNLEADED r 3. DIESEL r 6. AVIATION FUEL C\r 2. NON-FUEL PETROLEUM r 1c. MIDGRADE UNLEADED r 4. GASOHOL F99. OTHER F 3. CHEMICAL PRODUCT . F 4. HAZARDOUS WASTE(Includes ' COMMON NAME(from Hazardous Materials Inventory page)441 CAS#(from Hazardous Materials Inventory pa 4 Used Oil) V F 95. UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK r 1. SINGLE WALL r 3. SINGLE WALL WITH r 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) X 2. DOUBLE WALL EXTERIOR MEMBRANE LINER r 95. UNKNOWN r 4. SINGLE WALL IN A VAULT r 99. OTHER TANK MATERIAL-primary tank IF 1. BARE STEEL X 3. FIBERGLASS f 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 All 00%METHANOL r 99. OTHER REINFORCED PLASTIC(FRP) TANK MATERIAL-secondary IF 1. BARE STEEL X3. FIBERGLASS/PLASTIC r 8. FRP COMPATIBLE W/100%METHANOL r 95. UNKNOWN 445 tank r 2. STAINLESS STEEL IF 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 F95. UNKNOWN446 DATE INSTALLED 447 OR COATING r 2. ALKYD LINING r 4. PHENOLIC LINING X 6. UNLINED r 99. OTHER Check one item only) 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 IF 4. IMPRESSED CURRENT r 99. OTHER (Check one item only) PROTECTION (For Iotal 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 X 1. ALARM X 3. FILL TUBE SHUT OFF VALVE X 2. DROP TUBE r 2. BALL FLOAT r 4. EXEMPT X 3. STRIKER PLATE IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local 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/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons r Yes r No 6