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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,III,IV,and IX below) 430 ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION f.`' ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 4301 DATE EXISTING UST DISCOVERED: 430b T. FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ :' r_ BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO 02133 BUSINESS SITE ADDRESS 103 CTTY l04 2908 BENJAMIN HOLT DR STOCKTON II.'TANK DESCRIPTION TANK ID# 1 432 TANK MANUFACTURER 433 TANK CONFIGURAIION: THIS TANK IS 434 Modem Welding 0 LA STAND-ALONE TANK _ > J_i i ❑2.ONE .IN A COMPARTMENTED UNIT. I Com lele one page for each wm amnent is the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1999/04 12,000 1 IiL,TANKUSE'AND CONTENTS n TANK U SE ® la.MOTOR VEHICLE FUELING ❑ 1 b.MARINA FUELING ❑ lc.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(1--!tides Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(e)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a CONTENTS PETROLEUM: ® la.REGULAR UNLEADED ❑ lc.MIDGRADE UNLEADED ❑ lb.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATTON GAS [j8.PETROLEUM BLEND FUEL El9.OTHER PETROLEUM (Specify): 440- NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL El 11.OTHER NON-PETROLEUM Specify): 4406 r IV. TANK;CONSTRUCTIQN TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL Ll95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 44a ❑ 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 ❑ 95.1JNKNOWN ®99.OTHER(Specify): Steel Clad w/Fiberglass coating 445a OVERFILL PREVENTION ff 1.AUDIBLE&VISUAL ALARMS 02.BALL FLOAT ❑ 3.FILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V PR,. ODUCT/WASTEPIPING CONSTRUCTION SYSTEM TYPE ® 1.PRESSURE LJ 2.GRAVITY L13.CONVENTIONAL SUCTION ❑ 4.SAFE SU PIPING CONSTRUCTION ❑1.SINGLE-WALLED ®2.DOUBLE-WALLED ❑99.OTHER a6o CTTON 123 tete§2636(a)(3)3 458 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.RIGIDPLASTIC 464b ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c PIPING/TURBINE CONTAINMENT SUNIP TYPE ® 1,SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d VENT PRIMARYCONTTvTS YAP❑OR RECOVERY(VRiAND.'.�S oRIGIDILL PIPE PIPING CONSTRUCTION 1. 4. PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4641 46411 VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC N 90.NONE ❑ 99.OTHER(Specify) 464f 464fl VR PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4648 464R I VR SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE 99.OTHER(Specify) 464h 46441 VENT PIPING TRANSITION SUMP TYPE 19 1.SINGLE WALL [12.DOUBLE WALL [190.NONE 464E RISER PRIMARY CONTAINMENT ® L STEEL ❑ 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE Ll 99.OTHER(Specify) 464] 464.1 RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 464k 4601 FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 451a-c VII:UNDER DiSPENS - ER CONTAINIVIENT_(UDC) CONSTRUCTION TYPE ® I.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL [I1.STEEL ® 4.FIBERGLASS [110.RIGID PLASTIC El99.OTHER(Specify) 469b-o :VIII. CORROSIONPROTECTION a .. 448. STEEL COMPONENT PROTECTION F-12.SACRIFICIAL ANODE(S) [14.IMPRESSED CURRENT ® 6.ISOLATION _ 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 SIGNA DATE -. - 470. APPLICANT NAME(print NNI RSM. MARINAS a71. APPLICANTTITLE Environmental Compliance Spe?Rbt 472. UPCF UST-A Rev.(12/2007)