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UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(one iom per UST) TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections I,II,III,IV,and IX below) a3o ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL J DATE UST PERMANENTLY CLOSED: 4304 DATE EXISTING UST DISCOVERED: a30b I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO 02133 BUSINESS SITE ADDRESS 103 C]Ty 104 2908 BENJAMIN HOLT DR STOCKTON II,`TANK DESCRIPTION. TANK ID# 1 452 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 Modern Welding ®1.A STAND-ALONE TANK [:12.ONE IN A COMPARTMENTED UNIT. Complete one page for each compartment in the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 417 1999/04 12,000 1 �. . IIL:TANI{USEAND;CONTENTS TANK USE N la.MOTOR VEHICLE FUELING ❑ 1b.MARINA FUELING ❑ lc AVIATION FUELING .. , .... _. .•. 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] [16.OTHER GENERATOR FUEL ❑ 95.UNKNOWN El99.OTHER(Specify): 439a CONTENTS PETROLEUM: ® 12.REGULAR UNLEADED ❑ 1c.MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUMBLEND FUEL ❑ 9.OTHER PETROLEUM Specify): 440a NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL El 11.OTHER NON-PETROLEUM Specify): 4aob IV. TANK CONSTRUCTION TYPE OF TANK C11.SINGLE WALL ® 2.DOUBLE WALL El95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS El 6.INTERNAL BLADDER °4° ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444a SECONDARY CONTAINMENT ❑ 1.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7,JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ®99.OTHER(Specify): Steel Clad w/Fiberglass costing 445a OVERFILL PREVENTION ® 1,AUDIBLE&VISUAL ALARMS M 2.BALL FLOAT ❑ 3.FILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT Y, PRODUGTiIWASTE'PIPING CONSTRUCTION '.' PIPING CONSTRUCTION ❑1.SINGLE-WALLED ®2.DOUBLE-WALLED 1199.OTHER a60 SYSTEM TYPE ® L PRESSURE ❑ 2,GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(a)(3)1 45s PRIMARY CONTAINMENT ❑ 1.STEEL ® 4,FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGIDPLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464b ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c PIPING/TURBINE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d VI.VENT,.VAPOR:RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINME ❑ 1.STEEL N 4.FIBERGLASS El10.RIGID PLASTIC ❑ 90.NONE El99.OTHER(Specify) 464e NT 464e1 VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS 1110.RIGID PLASTIC ® 90.NONE El99.OTHER(Specify) 464f 464£1 VR PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4648 4641 VR SECONDARY CONTAINMENT ❑ L STEEL El4.FIBERGLASS [110.RIGID PLASTIC ® 90.NONE 0 99.OTHER(Specify) 464h 464h1 VENT PIPING TRANSITION SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL 90.NONE 4fi4i RISER PRIMARY CONTAINMENT ® 1.STEEL ❑ 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE Ll 99.OTHER(Specify) 464) 464'1 RISER SECONDARY CONTATNMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 464k 464kl FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 45la-c VII:UNDERDISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL [3 3.NO DISPENSERS ❑ 90.NONE 4694 CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS El10.RIGID PLASTIC El99.OTHER(Specify) = 459b-c VIII CORROSION,PROTECTION, f. STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ® 6.ISOLATION a4a. IX. APPLICANT:SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in full compliance with legal requirements. APPLICANT SIGNATURE/, DATE , alo. APPLICANT NAME(printt' NNI R,M. MARINAS 471' APPLICANT TITLE Environmental Compliance Sp e ' 477' UPCF UST-A Rev.(12/2007)