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UNDERGROUND STORAGE TANK' 6-11fIr OPERATING PERMIT APPLICATION-TANK INFORMATION(bne 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 ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 43oa DATE EXISTING UST DISCOVERED: 4306 .. ... •, ,:,Y �'ACIY,IT�I(�'(�1rMATION " FACILITY ID#(Agency Use Only) i BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO 02133 BUSINESS SITE ADDRESS 103 CITY IN 2908 BENJAMIN HOLT DRti STOCKTON TANK ID# 2 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK Is 434 Modem Welding ®1.A STAND-ALONE TANK lr ) _ ❑ 2.ONE IN A COMPARTMENTED UNIT. t' .%J T• ,/�r �,/C�' _ Complete one page for each com ailment in the wit DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1999/04 12,000 y1 TANK USE N le.MOTOR VEHICLE FUELING ❑ ]b.MARINA FUELING ❑ lc.AVIATION FUELING 439 ❑ 3•CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(0)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 439a CONTENTS PETROLEUM: N le.REGULAR UNLEADED ❑ lc.MIDGRADE UNLEADED ❑ lb.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440a NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL [j11.OTHERNON-PETROLEUM(Specify): 440b t Iv '�"A1�T CoI�S I LICT1.1 .... _ TYPE OF TANK ❑ 1.SINGLE WALL N 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444a SECONDARY CONTAINMENT ❑ 1.STEEL [13.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN N 99.OTIIER(Specify): Steel Clad w/Fiberglass Reinforced Plastic 445a 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 : .P1UbU1 WAPIP11�T ;CbNSTi�CtON, ! PIPING CONSTRUCTION ❑1.SINGLE-WALLED N 2.DOUBLE-WALLED ❑99.OTHER 460 SYSTEM TYPE N 1.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(ex3)] 458 PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ &FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 4646 ! ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464e PIPINGITURBINE CONTAINMENT SUMP TYPE N 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d ::�ifEl�f'I,'(V,�'UR FtECOV�TfX(V1�) . ,:R'�$�R I,FILLPll?`Iy PII�Il�1'I'x'CO1��T�UCTION. •_ ; ': '= VENT PRIMARY CONTAINMENT ❑ 1.STEEL N 4.FIBERGLASS 10.RIGIDPLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464e 464e1 VENT SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGIDPLASTIC N 90.NONE ❑ 99.OTHER(Specify) 464f 464n VR PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464s 464 1 VR SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC N 90.NONE ❑ 99.OTHER(Specify) 464h 464h1 VENT PIPING TRANSITION SUMP TYPE N 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464' RISER PRIMARY CONTAINMENT ® 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464j 464'l RISER SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGIDPLASTIC N 90.NONE ❑ 99.OTHER(Specify) 464k 464kl FILL COMPONENTS INSTALLED N 1.SPILL BUCKET N 3.STRIKER PLATEBOTTOM PROTECTOR N 4.CONTAINMENT SUMP 451&-0 SII.U1vIfER,DISPTS1R,C( AIlYIVIENT([JDC) ': :. , CONSTRUCTION TYPE ® 1,SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 4696-c xmt, coRRooNROTEC. �o STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT � 6.ISOLATION 448• CERTIFICATION:I certify that this UST sysCemA compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in fun com liance it al requirements. APPLICANT SIGNATURE DATE 470' APPLICANT NAME(print) BRATZ AGOITIA 471. APPLICANTTITLE Environmental Compliance Specialist 472. UPCF UST-A Rev.(12/2007) r