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UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(one form per UST) TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections I,II,❑,IV,and IX below) 430 c ® 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION t ❑ 6,TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ S.UST REMOVAL DATE UST PERMANENTLY CLOSED: 0301, DATE EXISTING UST DISCOVERED: 4306 i NACILITY.IN�'ORMATION FACILITY ID#(Agency Use Only) 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) - 3 ARCO 02133 �:�.� �_,�.... �. �.�;L�� .� BUSINESS SITE ADDRESS 03 CITY laa 2908 BENJAMIN HOLT DR STOCKTON i i II.:TArTKDSCRIPTOI�T � TANK ID# 1 432 TANK MANUFACTURER 433 TANK CoNFiGURATION: THis TANK is 434 Modem Welding ®1.A STAND-ALONE TANK - _. -,•/ - ❑ 2.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 437 1999/04 12,000 1 III SRAND G`(3NTPNTS i 43 TANK USE N ]a.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING ❑ 1 a AVIATION FUELING 9 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] ❑ 6.OTHER GENERATOR FUEL [195.UNKNOWN ❑ 99.OTHER(Specify): 4390 CONTENTS PETROLEUM: E la.REGULAR UNLEADED ❑ Ic. IDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440 M ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440a NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL 440b ❑ 11,OTHERNON-PETROLEUM S ecify: . _ IV. ;TANK CO�TSTRU��'XON TYPE OF TANK ❑ ].SINGLE WALL E 2.DOUBLE WALL L195.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL Ll3.FIBERGLASS ❑ 6,INTERNAL BLADDER a44 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444a SECONDARY CONTAINMENT El 1.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER [17.JACKETED 445 El90.NONE ❑ 95.UNKNOWN E 99.OTHER(Specify): Steel Clad wfFiberglass Reinforced Plastic 4050 OVERFILL PREVENTION 1.AUDIBLE&VISUAL ALARMS N 2.BALL FLOAT ❑ 3.FILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT PIP�i,G CONSTRUCTION '° . PIPING CONSTRUCTION ❑1.SINGLE-WALLED N 2.DOUBLE-WALLED 1199.OTHER 460 SYSTEM TYPE E 1.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(a)(3)] 458 PRIMARY CONTAINMENT El STEEL E 4.FIBERGLASS [18.FLEXIBLE ❑ 10.RIGID PLASTIC 464 INME ❑ 90.NONE [195.UNKNOWN [1 99.OTHER(Specify): 4640 SECONDARY CONTAINMENT ❑ 1.STEEL N 4.FIBERGLASS El 8.FLEXIBLE El 10.RIGID PLASTIC 4646 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c PIPING/TURBINE CONTAINMENT SUMP TYPE E 1.SINGLE WALL [1 2.DOUBLE WALL El 90.NONE 464d VI.VENT,VAPOR RE tY CVR).AND RISE / II,LPIly�;rtANd CdNSTRUCTIO�Y VENT PRIMARY CONTAINMENT ❑ 1.STEEL E 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90,NONE ❑ 99.OTHER(Specify) 4644 46441 VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC E 90.NONE ❑ 99.OTHER(Specify) 464f 464fl VR PRIMARY CONTAINMENT ❑ 1.STEEL E 4.FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) a6ag 464 l VR SECONDARY CONTAINMENT ❑ 1.STEEL [:] 4.FIBERGLASS ❑ 10.RIGID PLASTIC E 90.NONE El99.OTHER(Specify) 464h 464bl VENT PIPING TRANSITION SUMP TYPE E 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464i. RISER PRIMARY CONTAINMENT E 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC [190.NONE El99.OTHER(Specify) 4fi4i 464'1 RISER SECONDARY CONTAINMENT 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC E 90.NONE ❑ 99.OTHER(Specify) 464k 4641 FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET E 3.STRIKER PLATE/BOTTOM PROTECTOR E 4.CONTAINMENT SUMP VIL 1UNDEIt,DT$0XSEI�CONTAINMENT' C) CONSTRUCTION TYPE ® 1.SINGLE WALL [12.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 4690 CONSTRUCTION MATERIAL ❑ 1.STEEL E 4.FIBERGLASS ❑ 10.RIGIDPLASTIC ❑ 99.OTHER(Specify) 469b-c ', � ...:VIII. CORROSION PROTEGTIO�T ' . STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT CY6 ISOLATION 448' IX.'APPLICANT:SYGNA'xURE CERTIFICATION: I certify that this UST syst ompatible with the hazardous substance stared and that the information provided herein is true,accurate, and in full com Bance al re uirements. APPLICANT SIGNATURE DATE q a ago. C� APPLICANT NAME(print) BRA ASAGOITIA 471' APPLICANT TITLE Environme tal Compliance Specialist 472. I UPCF UST-A Rev.(12/2007) i