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UNIFIED PROGRAM CONSOLIDATED FORM la ILf 1 D UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION(ow form pct USI) INFIL OF ACTION (Check one item on1. Foran UST permanent closure or rcnwval.conlpicte onl) this section and Sections I.11.111.IV.and IX helow) ❑ I NEW PERMIT ❑ 3 RENEWAL PERMIT ❑ 5.CHANGE•OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ® 7, UST PERMANEN•f CLOSURE ON SITE ❑ 8,LIST REMOVAL DATE(1ST PERMANENTLY CLOSED:12/31/2010 439n DATE EXISTING UST DISCOVERED: rob 1. FACILITY INFORMATION FACILITY ID#(Agency Use On1);1 _ _ ,3 3 I BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO#06080 BUSINESS SITE ADDRESS Ina CITY 104 85 East Lousie Avenue Lathrop II.TANK DESCRIPTION TANK ID# l 431 TANK MANUFACTURER 433 'TANK CONFIGURATION: THIS TANK IS 434 Owens Corning ®1.A STAND-ALONE TANK ❑2.ONE IN A COMPARTMENTED L NIT, 66220 1 complete one pue for each com emnent in the unit ATG ITST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1984/10 12,000 1 111.TANK USE AND CONTENTS TANK USE ® Ia.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ Ic.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL IHSC k252a l 5(c)) ❑ 6,OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (S ecifv): 4398 CONTENTS PETROLEUM: 0 la,REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 0 ❑ 3 DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8,PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 44U8 NON-PETROLEUM 7 USED OIL ❑ 10 ETHANOL ❑ 11,OTHER NON-PETROLEUM(Specify): 440b IV. TANK CONSTRUCTION TYPE OF TANK 0 1 SINGLE WALL 0 2.DOUBLE WALL 0 95.UNKNOWN 443 PRIMARY CONTAINMENT ❑ 1 STEEL 0 3 FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 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.OTHERS cif 445n OVERFILL PREVENTION 0 1.AUDIBLE&VISUAL ALARMS §P 2 BALL FLOAT 6 3.FILL TUBE SHUT-OFF VALVE 452 ❑ 4 TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑I SINGLE-WAI.I.En 0 2.DOUBLE-WALLED 99.OTHER 460 SYSTEM TYPE 0 1.PRESSURE ❑ 2.GRAVITY 3,CONVENTIONAL SUCTION 4 SAFE SUCTION(23 CCR f2Q6(,Xj)I 458 PRIMARY CONTAINMENT 1 STEEL ❑ 4;FIBERGLASS U 8.FLEXIBLE 0 10 RIGID PLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ® 99.OTHER(S ity); 464n SECONDARY CONTAINMENT 0 1.STEEL. ❑ 4:FIBERGLASS El S.FLEXIBLE ❑ 10,RIGID PLASTIC 464b ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER( ): 464c PIPING/TURBINL CONTAINMENT SUMP TYPE. I SINGLE WALL Ll 2,DOUBLE WALL ❑ 90.NONE 464d V1.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT I STEEL 0 4 FIBERGLASS 10.RIGID PLASTIC El 90.NONE 99.OTHFR(Specify) 464c 46481 VENT SECONDARY CONTAINMENT C3 1,STEEL 4 FIBERGLASS 10.RIGID PLASTIC 13 90.NONE 99.OTHER(Specify) 4641' 464n VR PRIMARY CONTAINMENT E3 1.STEEL 04 FIBERGLASS 10 RIGID PLASTIC 90.NONE i 9 OTHER(Specify) UAB .164MI VR SECONDARY CONTAINMENT C1 i STEEL 4 FIBERGLASS 10.RIGID PLASTIC 0 90,NONE 13 99 OTHER(Specify) *Ah -- 46411 VENT PIPING TRANSITION SUMP TYPE 1.SINGLE WALL 2,DOUBLE WALL. 90•NONE 4641 RISER PRIMARY CONTAINMENT Ll 1,STEEL 4 FIBERGLASS U 10,RIGID PLASTIC Lj 90,NONE Ej 99,OTHER(Specify) 464j 464'1 RISER SECONDARY CONTAINMENT C3 I.STEEL ❑ 4 FIBERGLASS C1 10.RIGID PLASTIC 90.NONE 99.OTHER(Specify) 464k 464k1 FILL COMPONENTS INSTALLED 1,SPILL BUCKET 3 STRIKER PLATE/BOTTOM PROTECTOR C3 •1 CONTAINMENT SUMP 4 le-c VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ❑ 1 SINGLE WALL ❑ 2 DOUBLE WALL 0 3 NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL ❑ ],STEEL ❑ 4.FIBERGLASS 0 10.RIGID PLASTIC M 99 OTHER(S f) 46%-c VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2 SACRIFICIAL ANODE(S) ❑ 4 IMPRESSFD CURRENT ❑ 6 ISOLATION 449 IX. APPLICANT SIGNATURE CERTIFICATION: 1 certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is(rue,accurate, and in full compliance with legal requirements. APPLICANT SIGNATURE DATE 470 APPLICANT NAME(print) R.C. OSsett 471 APPLICANT TITLE Environmental Compliance Specialist 47 IIPCF•LIST-B-1/2 Rev.(12/2007)