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May 11 0903:46p MVP Petroleum Engineering 916-984-1117 p.2 ' o UNIFIED PROGRANT CONSOLIDATED FORM b UNDERGROUND STORAGE TANKMI /�� all /{ OPERATING PERT APPLICATION-TANK INFORMATION (One form per UST) TYPE OF ACTION ('Check one item only. Por a UST closure or reawral.cornpiete only this seuiwl and Sections 1.!l.1/1,iV.mrd LY belouq a ❑ I.`'EW PERMIT ❑ 3.RENEWAL PERMIT CHANGE OF INFORMATION ❑ 6.TEYIPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE FS.UST REMOVAL DATE UST PERMANENTLY CLOSED: 411m I DATE EXISTING UST DISCOVERED: 43ob. L FACILITY INFORIVIATION i•ACILITY ID r?(Agency Lyse Onh) BUSINESS NAME(Same as Facilih,:Vome or DBA-Doing Busirress,4s; ; BUSINESS SITE ADDRESS 1m. CITY taR. s. ta? S7_ II. TANK DESCRIPTION R`ID h Y' FANK MANUFACTURER TANK CONFIGURATION:THIS TANK IS 434• 1 ASTAND-ALONE TAATK Co plxconepape for euh JJJ z/lv i`r-i�.r 2.ONE INA CaMPAR-Ik1ENTED LrNiT spa mrntm,he unit DATE UST SYS'Mi INSTALLED i3= TANK CAPACITY IN GALLONS NUMBER OF COMPARTMENTS fN THE UNIT 437. N of (!!71; III. TANK USE AND CONTENTS TANK USE W Ia.MOTORVEHICLEFUELRTG ❑ Ib.NIAR)NAFUEI.ING ❑ 1GAVIATICNFUELING 439. C33.CHEMICAL PRODUCT STORAGE ❑ 4.HA7-ARDOUS l4:ASTE Ta<tudes u.-d od) ❑ i.F-MERGENCY Gla%ERATOR FUEL pw§xs2su(c)) __ _ _ __,❑ 6;OTHER GENERATOR FUEL _ ❑ 95_UNKnOWN_ _ _ _❑_ 99.OTHER t39a CONTENTS PEntOLEU?6E ❑ In.REG:A AR U7JLEADFD ❑ Ic.MIDGRADE UNLEADED ❑ Ib.PRMfILJ d UNLEADED t^a- 3DIESEL ❑ SAET FUEL C16.AVIATION GAS R.PETROLEUM BLEND FUEL ❑ 9.OTHE-R PEfROLEUXI(Specif-) WOi NON-i�-CROLEIJy[:❑ 7.USED OIL ❑ 10.ETHA;JOL ❑ 1I-OTNERNON-PETItOLEUle1(S xifv)- 440b. IV. 'TANK CONSTRUCTION TYPE Or TANK -❑ I.StT1uLE WALL] Z_DOUBLE WALL ❑ 9i;UNKN0IVN 443. PRIMARY CONTAINMENT 1.STEEL ❑ 3.FIBERGLASS [36.INTERNAL BLADDER 4i4 _-T_•_- --_-- - -- i_SEL. I•E +lArCERNAL LNING ❑ 95_ NT UECNOR'iI_ u 0 99.OTHER(Specify): a . SECONDARY CONTA[I�TMENT ❑ 1_STEEL (93.FIBERGLASS C36.EC:ERIOR MENIBRANE LINER [37.JACKETED L45 I ❑ 90.NONE ❑ UNKNOWN Nl;vW>I o [199.oTHER;Spccifr): 4 s ------ ----------- -- --NKN N --•-- --- L OVERFILL PR=VENTTTON 1.AUDIBLE 8;.VISUAL ALARMS ❑ 2.BALL FLOAT i Ep 3.FILL TUBE SHUT-OFT VALVE as' 4.TANK:.MEET'S REQUIREMENTS FOR E\ENf?TION FRO&I OVERFELL PREVENTION EQUIPMENT V. PRODUCT IWASTE PIPING CONSTRUCTION _PIPING CONSTRUCTION_ ❑ I.SINGLE WALL �.f30L'BLE LVALL ❑ 99-OTHER 460 ---.... - --- - -------------.:.-------------------------------- ---......_..._ SYSTE TYPE (A I. j!ESSURE Z.GRAVITY ❑ 3.CONVENTIONhLSUCTION ❑ 4✓SAFESUCTtO9(27UCR¢2636ta)13p - - 45s.- PRlN1ARY CONTAINNI%NT ❑ 1.STEEL 2.FIBERGLASS ❑ &FLEKIBLE ❑ I0.R1G1D PLASTIC A" _ __ __ _ 90.NONE ❑ 95.UT4ICN01V\' 16 0. ❑ 99.G"IT-lER jSpeviCv)_ _ __ SECONDARY CONTAINMENT ❑ 1.STEEL AL 4.FIBERGLASS ❑ S.FLEMBLE ❑ 10.RIGID PLASTIC ^- 44' 0_90-ND_NE _ ❑ 95.1:Nt.\O'NN _ ❑ 99.OT.4ER(Specifv)_ :b+c PIPINGrrURBINECONTAINMENT SUNIPTYPE-----1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.t•ONE --ate VI. VENT,VAPOR RECOVERY (VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMEIQT ❑ I.STEEL U'4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE TONE ❑ 99.07-HER(SpLeN): 4 ___----- -------- ._- VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS [1 10.RIGID PLI.STIG p 90 -,'ON ❑ 99 OTHER(Specify): 46at9. - - ------ - --- - - .-...__.- -- ---7�- - -- ---- -- -- VR PRIMARY CONTAINMENT Q I.S['EEL 0&4_FIBERGLASS ❑ 10_RWIDPLASTIC° ❑ 90_NONE ❑ 99.OTHER(Specify): +3� VR SECONDARY CONTAINMENT ❑ I.STEEL ❑ ;.FIBERGLASS ❑ 10 RfGID PL 4STIC .90.N01`L ❑ 99.OTHER(Speci Cy)- 446yj: 1 _ . _..-------..........._...._..._._..-•------_----- ---- -----------..._..--- _ ------- ----....._ - I V [1 [3ENT PIPING TRANSITION SUMP TYPE 1.SINGLE WALL 2 90.NON DOUBLE tIALL E 464i. __ _ RISER PRIMARY C_ONTAINb1ENT K1.STEEL ❑ 4_FfBERGLASS ❑ 10.RIGID PLASTIC C390.NONE ❑ 99.OTr1EK(SpeciF•): fit' RISERSE-CONDARYCONTAINMENT ❑ I.STEEL ❑ 4.FIBERGLASS ❑ IO.RI GID PI-ASTIC _❑ 90.NONE ❑ 99.OT-HER(Specili-): 46,kk FILL COMPONENTS INSTALLED LC I.SPILL BUCKET �- 3.STRIKERPL9TEIBOTTO,NI PROTECTOR ❑ 4-CON TAINNIENTSUMP 451st VII. UNDER DISPENSER CONTAMEENT(UDC) CONSTRUCTION TYPE SINGLE WALL ❑ 2.DOUBLE IVALL ❑ 3.NO D1SPE LASERS ElW.NONE 469b. CONSTRUCTION MATERIAL ❑ 1.ST---Lf- 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) � VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODES ❑ 4,i\•IPRESSw CURRtrMC Ig 6.ISOLATION � IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous subspace stored and that the information provided herein is true, accnnte,and in full cam dance with legal requirements. 470. APPLICANT SIGNATOR DATE a 0 APPLICANTNAME(pr' t-/ APPLiC_��17'TITLE 47-7v UPCF UST-8 Rev.(12/2007)-1/2 %vumanidocs.ore