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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(one fo TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections L 11,Ill,IV,and IX elow) ° ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430a 1 DATE EXISTING UST DISCOVERED: 4306 I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) 1 BUSMESS NAME(Same as FACILITY NAME or DBA-Doing Business As) Arco Manteca BUSINESS SITE ADDRESS 103 CITY 104 1711 E.Yosemite Ave Manteca L TANK.DESCRIPTION .. . TANK ID# 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS YANK IS 474 2-Plus �� Q -( Z ®1.A STAND-ALONE TANK ❑2.ONE M A COMPARTMIENTED UNIT. Complete one Page for each com anmem in the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY M GALLONS 416 NUMBER OF COMPARTMENTS IN THE UNIT 477 14976 I�r III:TANK USE AiYD;CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING ❑ Ic.AVIATION FUELING azo ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC 425281.5(c)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a CONTENTS PETROLEUM: ❑ Ia.REGULAR UNLEADED N Ic.MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440. NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUM(S ecif): 4.10b IV.'.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 447 PRIMARY CONTAINMENT ❑ 1.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444. SECONDARY CONTAINMENT ❑ 1.STEEL ®3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify) 445a OVERFILL PREVENTION N I.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT i2 3.FILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT a Y * ''S 11V DUCT-14 t#STE'PIPING CO., PIPING CONSTRUCTION ❑I.SINGLE-WALLED ®2.DOUBLE-WALLED ❑99.OTHER 460 SYSTEM TYPE ® 1.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(a)(3)] 458 PRIMARY CONTAINMENT ❑ 1.STEEL. ® 4.FIBERGLASS ❑ S.FLEXIBLE ❑ 10.RIGID PLASTIC 764 ❑ 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(S eci : 464c PIPINGITURBINE CONTAH*AENT SUMP TYPE ® I.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d VI 'VENT;VAPQR RI+;COYERY'�yR)'AND'RISER 7 FILL PIPE PIPING�CONSTRIJCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL IM 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) a6,10ae1 VENT SECONDARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464f 464n VR PRIMARY CONTAINMENT ❑ I.STEEL N 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE 99.OTHER(Specify) 4648 464XI VR SECONDARY CONTAINMENT 0 I.STEEL E9 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE C1 99.OTHER(Specify) 464h 464h1 VENT PIPING TRANSITION SUMP TYPE N I.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464i. RISER PRIMARY CONTAINMENT N I.STEEL 4.FIBERGLASS ❑ 10.RIGID PLASTIC 90.NONE 0 99.OTHER(Specify) 464'464.)1 RISER SECONDARY CONTAINMENT ❑ 1.STEEL 19 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464k 464k1 FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR 4.CONTAINMENT SUMP 451rc `'VII:UNDER`bISPENSEIt:CONfiAIIYMENT(UDC) CONSTRUCTION TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 4694 CONSTRUCTION MATERIAL ❑ 1.STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Speci 4696-° .; .::, �:, . ., :VIII,'•CORROSION PROTT•a.CTION. : ` � , STEEL COMPONENT PROTECTION El2.SACRIFICIAL ANODE(S) [14.IMPRESSED CURRENT N 6.ISOLATION 448 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. 470. APPLICANT IGNATURE DATE -.- 4/15/2011 APPLICANT NAME(print) 471' APPLICANT TITLE a72. Gurdeep Singh President UPCF UST-B-1/3 Rev.(12/2007)