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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 ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430a DATE EXISTING UST DISCOVERED: ) 430b L FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) r 3 ARCO 02133 BUSINESS SITE ADDRESS 103 CITY 104 2908 BENJAMIN HOLT DR ISTOCKTON ._ _ ,,.: .._ '=: II TtA►NI{.DESGRIPTIONi TANK ID# 3 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK Is 434 C' Modem Welding ®1.A STAND-ALONE TANK r `"t,:,-'_:r."' �ti, ❑2.ONE IN A COMPARTMENTED UNIT. Com tete one page for each co anent in the unit. _ DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1999/04 10,000 1 TII.TANK USE�4ND CONTENTS... , <` TANK USE ® la.MOTOR VEHICLE FUELING [I Ib.MARINA FUELING ❑ lc.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL.[HSC§25281.5(e)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439& CONTENTS PETROLEUM: ❑ l a.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): 44oa NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ IL OTHER NON PETROLEUM(Specify): L ZV, TANK COjSTI2 CTIQN; . i TYPEO F TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 l ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444a h SECONDARY CONTAINMENT ❑ 1.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN N 99.OTHER(Specify): Steel Clad w/Fiberglass coating 445& 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 PREVENTIONEQUIPMENT `7RODUCTIWASTE`PIPINGCCSNSTRUCTIOT,, PIPING CONSTRUCTION ❑1.SINGLE-WALLED ®2.DOUBLE-WALLED ❑99.OTHER 460 SYSTEM TYPE ® 1,PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(.)(3)] ass PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑ 90,NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464& SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464b ❑ 90,NONE [195.UNKNOWN [399.OTHER(Specify): 464° PIPING/TURBINE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 4644 VI..VEIN VAPOR,RECOVF1tX(VR)AN4 RISER�FII;L PIIs��'IPYIYG OON5tRIXTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464e t VENT SECONDARY CONTAINMENT ❑ 1.STEEL [14.FIBERGLASS ❑ 10.RIGIDPLASTIC ® 90.NONE [199.OTHER(Specify) 464f VR PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464g VR SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGIDPLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 464h VENT PIPING TRANSITION SUMP TYPE ® 1,SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 4641. RISER PRIMARY CONTAINMENT ® 1.STEEL [14.FIBERGLASS ❑ 10.RIGIDPLASTIC ❑ 90.NONE [199.OTHER(Specify) a6a3 464'1 RISER SECONDARY CONTAINMENT ❑ 1.STEEL [14.FIBERGLASS E] 10.RIGID PLASTIC ® 90.NONE [199.OTHER(Specify) 464k 464k1 FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET N 3.STRIKER PLATE/BOTTOM PROTECTOR ® 4.CONTAINMENT SUMP 451&-c YII UNDER DISPENSEi .G01yTATNMEI�TT(IJDC) CONSTRUCTION TYPE ® L SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS El 10.RIGIDPLASTIC ❑ 99.OTHER(Specify) - 4696c 3 VIII. CORROSION PROTEOT1ON Iss., R < STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) [14.IMPRESSED CURRENT N 6.ISOLATION -- 449, APPLICANT SXGNATYJRE a CERTIFICATION:I certify that this UST system is compatible with the hazardous substance stored and that the information provided herepi is,true,accurate, and in full compliance with legal requirements. APPLICANT SIGNATURE/�, DATE _ 470' APPLICANT NAME(print)/JFNNIFItrUA. MARINAS 471- APPLICANT TITLE Environmental Compliance nlist a72. UPCF UST-A Rev.(12/2007)