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UNDERGROUND STORAGE TANK V91 OPERATING PERMIT APPLICATION-TANK INFORMA1710 (one�rm per UST) TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,H,III,IV,and IX below) 430 ii 1.NEW PERMIT [1 3.RENEWAL PERMIT [:1 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE El 7.UST PERMANENT CLOSURE ON SITE El 9.UST REMOVAL is DATE UST PERMANENTLY CLOSED: 430. DATE EXISTING UST DISCOVERED: 430b FACILITY ID#(Agency Use Only) inj'il:;:' BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 ARCO 02133 BUSINESS SITE ADDRESS 103 CITY 104 2908 BENJAMIN HOLT DR STOCKTON TANK ID# 3 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK is 434 Modern Welding Ej 1.A STAND-ALONE TANK El 2.ONE IN A COMPARTMENTED UNIT. Complete one page for each compartment in The unit. 437 DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 1999/04 10,()00 TANK USE 0 ]a.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING 0 Ic.AVIATION FUELING 439 El 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used OH) [3 S.EMERGENCY GENERATOR FUEL[Hsc§252s1.5(c)] [1 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN [3 99.OTHER(Specify): 439a CONTENTS PETROLEUM: 0 Ia.REGULAR UNLEADED El Ic.MIDGRADE UNLEADED 10 Ib.PREMIUM UNLEADED 440 is El 3.DIESEL ❑ 5.JET FUEL Cj 6.AVIATION GAS ❑ 9.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440s NON-PETROLEUM:0 7.USED OIL ❑ 10.ETHANOL 440b 0 11.OTHER NON-PETROLEUM(Sp�cff TYPE OF TANK U 1.SINGLE WALL N 2.DOUBLE WALL U 95.UNKNOWN 443444 PRIMARY CONTAINMENT N 1.STEEL [13.FIBERGLASS [16.INTERNAL BLADDER ❑ 7.STEEL+INTERNAL LINING [1 95.UNKNOWN D 99.OTHER (Specify): 444a SECONDARY CONTAINMENT El 1.STEEL L]3,FIBERGLASS 0 6.EXTERIOR MEMBRANE LINER [1 7.JACKETED 445 [1 90.NONE [3 95.UNKNOWN 0 99.OTHER(Specify): Steel Clad w/Fiberglass Reinforced Plastic 445a OVERFILL PREVENTION 0 1.AUDIBLE&VISUAL ALARMS N 2.BALL FLOAT U 3.FILL TUBE SHUT-OFF VALVE 452. El 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT C R A PIPING CONSTRUCTION 0 1.SINGLE-WALLED D9 2.DOUBLE-WALLED [199.OTHER 460 SYSTEM TYPE N 1.PRESSURE [1 2.GRAVITY El 3.CONVENTIONAL SUCTION 0 C SAFE SUCTION[23 CCR§2636(a)(3)] 459 PRIMARY CONTAINMENT 0 1.STEEL 0 4.FIBERGLASS E] 9.FLEXIBLE ❑ 10.RIGID PLASTIC 464 [1 90.NONE [j 95.UNKNOWN El 99.OTHER(Specify): 464a SECONDARY CONTAINMENT ❑ 1.STEEL Dg 4.FIBERGLASS 1] 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464b ❑ 90.NONE [1 95.UNKNOWN [1 99.OTHER(Specify): 464c PIPING/TURBINE CONTAINMENT SUMP TYPE 1.SINGLE WALL ❑ 2.DOUBLE WALL Lj 90.NONE 464d _NG VENT PRIMARY CONTAINMENT Lj 1.STEEL El 4.FIBERGLASS Lj 10.RIGID PLASTIC Lj 90.NONE 0 99.OTHER(Specify) 464e 464el 464f VENT SECONDARY CONTAINMENT ❑ 1.STEEL 0 4.FIBERGLASS [310.RIGID PLASTIC [D go.NONE [] 99.OTHER(Specify) 464fl TIC 464g VR PRIMARY CONTAINMENT ❑ 1.STEEL 0 4.FIBERGLASS ❑ Io.RIGiDPLAS [1 90.NONE [1 99.OTHER(Specify) 464 1 VR SECONDARY CONTAINMENT ❑ 1.STEEL 0 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE El 99.OTHER(Specify) 464h1 TYPE E3 2.DOUBLE WALL Ej 90. 4"L VENT PIPING TRANSITION SUMP 0 1.SINGLE WALL NONE RISER PRIMARY CONTAINMENT 0 1.STEEL 0 4.FIBERGLASS 0 10.RIGID PLASTIC [1 90.NONE ❑ 99.OTHER(Specify) 464] 464jl RISER SECONDARY CONTAINMENT 0 1.STEEL El 4.FIBERGLASS [I 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 464k 46441 FILL COMPONENTS INSTALLED 0 1.SPILL BUCKET 0 3.STRIKER PLATE/BOTTOM PROTECTOR 0 4.CONTAINMENT SUMP 451&-e CONSTRUCTION TYPE 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS [1 90.NONE 469a CONSTRUCTION MATERIAL ❑ 1.STEEL 0 4.FIBERGLASS [3 10,RIGID PLASTIC ❑ 99.OTHER(Specify) 469b-c c PS H STEEL COMPONENT PROTECTION 0 2.SACRIFICIAL ANODE(S) 0 4.IMPRESSED CURRENT 6.ISOLATION 448. APLtCANis CERTIFICATION:I certify that this UST s; compatible t , a tible with the hazardous substance stored and that the information provided herein is true,accurate, � and in full compliance/w %I - APPLICANT SIGNATURE i eg requirements. DATE 470. APPLICANT NAME(print) BRA TZO-RMAGOITIA 471, APPLICANT vironmental Compliance Specialist 472. UPCF UST-A Rev.(12/2007)