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FIED PROGRAM CONSOLIDATED FO TANKS UNDERGROUND STORAGE TANKS-TANK PAGE 1 (two pages per tank) Page_,of__ TYPE OF ACTION [31. NEW SITE PERMIT [:]4. AMENDED PERMIT ®5. CHANGE OF INFORMATION) [-]6. TEMPORARY SITE CLOSURE (Check one item only) ❑7. PERMANENTLY CLOSED ON SITE ❑3. RENEWAL PERMIT []8. TANKREMOVED 430 (Specify reason-for locol use only) (Specify change-for local use only) BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 FACILITY ID# nI Tosco Corporation#255886/5886/31010 It) �-; � zda F � LOCATION WITHIN SITE(Optional) 431 I.TANK DESCRIPTION (A scaledplot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑ Yes No 434 J00l, If❑Yeses,complete one page for each compkm DATE INSTALLP 4EARIMO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 !;- l.4 000 f ADDITIONAL DESCRIPTION(For local use only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 . MOTOR VEHICLE FUEL ❑In. REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL (If marked,complete Petroleum Type) . PREMIUM UNLEADED ❑ 3. DIESEL ❑ 6. AVIATION FUEL ❑ 2. NON-FUEL PETROLEUM ®Ic. MIDGRADE UNLEADED ❑ 4. GASOHOL ❑99. OTHER ❑3. CHEMICAL PRODUCT ❑ 4. HAZARDOUS WASTE(Includes COMMON NAME(from Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) 442 Used Oil) ❑95. XERXES III.TANK CONSTRUCTION TYPE OF TANK ��❑1. SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) / 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ❑95. XERXES ❑ 4. SINGLE WALL IN A VAULT ❑99. OTHER TANK MATERIAL-primary tank >j BARE STEEL []3. FIBERGLASS/PLASTIC [:15. CONCRETE ❑95. XERXES 444 (Check one item only) /"❑2. STAINLESS STEEL [:]4. STEEL CLAD W/FIBERGLASS ❑8. FRP No W/100%METHANOL ❑99. OTHER REINFORCED PLASTIC FRP TANK MATERIAL-secondary tank ❑1 BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑8. FRP COMPATIBLE W/100%METHANOL 55. XERXES 445 (Check one item only) ❑2. STAINLESS STEEL N<4. STEEL CLAD W/FIBERGLASS ❑9. FRP NON-CORRODIBLE JACKET ❑99. OTHER REINFORCED PLASTIC(FRP) [:]10. COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING ❑ 1. RUBBER LINED [:13. EPDXY LINING ❑5. GLASS LINING ❑95. XERXES 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4. PHENOLIC LINING . UNLINED ❑99. OTHER Check one item only) For local use only) OTHER CORROSION El1. MANUFACTURED ><FIBERGLASS REINFORCED PLASTIC ❑95. XERXES 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE CATHODIC ❑4. IMPRESSED CURRENT ❑99. OTHER PROTECTION (Check one item only) ❑2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(For local use only) 451 OVERFILL PROTECTION EQUIPME YEAR INSTALLED n 452 (Check all that apply) kyr SPILL CONTAINMENT O ^ ❑1. ALARMS FILL TUBE SHUT OFF VALVE / !v PIT—qp� ❑2. BALL FLOAT ❑4. EXEMPT STRIKER PLATE IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK(Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER(Check one item only): 454 ❑1, VISUAL(EXPOSED PORTION ONLY) ❑5. MANUAL TANK GAUGING(MTG) ❑1. VISUAL(SINGLE WALL IN VAULT ONLY) ❑2. AUTOMATIC TANK GAUGING(ATG) ❑6. VADOSE ZONE CONTINUOUS INTERSTITIAL MONITORING ❑3. CONTINUOUS ATG ❑7. GROUNDWATER 03. MANUAL MONITORING ❑4. STATISTICAL INVENTORY RECONCILIATION(SIR)+ F-18. TANK TESTING BIENNIAL TANK TESTING ❑99. OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL'? 457 Rallons i_ Yes No UPCF(1/99 revised) Formerly SWRCB Form B