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05/20/2004 09:25 7074464 CAL INC PAGE 05 IL 4 UNIFIED PROGRAM CONSOMATED FORM TANKS UNDERGROUND STOR4GE TANKS-TANK PAGE I (Two pages per tank) Pago I'UE2 TYPE OF ACTION ❑ 1•NEW PERMIT ❑ 4.AMENDED PFRMrr 0 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY TANK CLOSURE 430. (Chaok m roam only) q 3.RENEWAL PERMIT --..._,--- GD(:Installation ❑ 7.PERMANENTLY CLOSED ON SITE (Spacifyreswon) (Specifyraaeon) ❑ 8.TANK MOVED BUSINESS NAME Ma wPACUJTYNAME or08A-DolagliusmWAS) a, FACI[dTYF1)-. 1• J. Son Joaquin County ShefiffMotor Pool LOCATION WITHIN SITE(00.4) 431, Approximately 1/2 wile down Michael N.Canlis on the Tight 11 and side near Harty Lane is'TANK DESMPTION A scaled ptot F&tl With the loeatiem Ofthe UST stq!i Inc uding buil 6 god landtriaiks shall bo sabmit(cd to the lo4al a 4m TANK ID# 432. TANK MANUFACTURER 433, COMPARTMENTALIZED TANK ❑Xos No 434. Opt Al 49 7p Qwcns/Corning Fiberglas a'Yea'op3 oda one pap ibr owk wropmanct. ]DATE IN 435, TANK CAPACITY IN GALLOttS 43s NUMBEP OF COMFA tMENTS 437. (YEAR/MO) 11/89 25,000 1 ADDITIONAL DESCRIFTFON a,-1-1 as.amty;) 438. Model DWT-2S(10)25000 Ix.TAr(x CONLINTS TANK U5E 4-J- PETROLEUM TYPE 440. 13 1. MOTOR VEHICLE FUEL ®I& REGULARUNLEAj)rD 02. LEADED ❑5, ISTRTRL (1fotmked,00mpldePdroleum'1 &j E3 lb. PRILN&ILMUNLEADED [3 3, D19S)ZL ❑6. AVIATION CAS ❑ 2. NOV-FUEL PETROLEUM 13 Ic.MIDGRADE UNLEADED ❑4. (iASOFIOL ❑99.OTHER; ❑ 3, CIIEMICALPRODUCT COMMON'NAME (fian,31av4ou4Mmer1n11 nvd=gpegs) 441' #11rrmHaranhnmA4abaidk1MbrtoNpb>OCC) 442• ❑ 4. IIAZrARWUS WASTE' _N/A- -N/A- (blk',tu0ea(:Re4n1f) ❑ 95.UNKNOWN .III.TANK CONSTRUCTION TYPE OF TANK ❑1.SINGLE WALL [13. SINGLE WALL WITH EXTERIOR ❑5, SINGLE WALL WITH INTERNAL fiLADDBR SYSTEM 443. (Cllaol:ono itma Only) MEMBRANE DINER ❑95. UNKNOWN 1 DOUBLE WALL ❑4. SIIYULE WALL IN A VAULT99,OTIIER TANKMATERIAL-prmaryiank 1.BARESTEEL ®3. FIBERGLASS'PLASTIC s. CONCRETE ❑95,UNKNOWN 444. (Chi k o k4m only) ❑2.STAINLESS STEEL ❑4.STEEL CLAD WMBERM ASS ❑R. FRP COMPATIBLE ❑99.OTHER: REINFORCED PLASTIC FRP W/I00%MET8ANOL TANK MATERIAL-eecond y tmk ❑3. BARE STEEL 3. FIBRROLA83/PLASTIC ❑8,FRP COMPTIBLE W/100'yo METHANOL El 95.UNKNOWN 445, (Check one item only) ❑2. STAINLESS STEEL❑4.STEEL CLAD W/FIBERGLASS L39. FRP N014.0011RODA]3ME JACKET 99.OTHER REINFORCED MASTIC(FRA') ❑10.COATED STCF.I, ❑S.GONCRFTE TANK INTERIOR LINING ❑I-RUBBER LTNEO ❑a.EPDXY LIVING 0 5.GLASS LINLNG 19 95.UNKNOWN 444, DATEINSTALLED 447. OP COATING ❑2.ALKYD LINING ❑4.PHENOLIC LINING ❑6.UNLINED 1199.OTIIEP._-__ (Check cute item on O•THEk CORROSION 1,MANUFACTURED CATHODIC ❑3,FIBERGLASS REINFORCED PLASTIC. 1995.UNSNOWN 448. DATE IN'STA'LLED 449. PROTECTION PROTRCTION ❑4.]MPRES:3ED CURRENT ❑99.OfrHF,R IfA lloobke ❑2.SACRIFICIAL ANODE SPILL AND OVERFILL YEARINSTALLED 450 1 TYPE 451. OVP,RFILT,PROTECTION E UIPMENT: YEARINSTALLED 457. (Chock all ftl apply) ®1.SPILL CONTAINMENT 2004_..,,- Phil-Tice ❑1.ALARM _ 3.FILL TU15E SITUP OFF VALVE 192.DROP TUBE 2004OPlV ®2,BALL FLOAT 2004-❑4.EXIDAPT ❑3.STRIKER PLATE W.TANK I,EAK DETECTION A doscri ran of tho moait�it p.vsrmt shat)he sub�ivitted V tllc Ioc2I y,} IF SINOLb WALL TANK 453. IF DOUBLE WALL TANK OK TANK WITH BLANDER 454. Check all that apply) (Chock one ium only) 1.VISUAL(EXPOSED PORTION ONLY) ❑5.MANUAL TANK GAUGING(1v1TG) ®1.VISUAL(SINGLE WALL 1N VAULT ONLY) ❑2.AUTOMATIC TANK GAUGING(ATG) ❑6.VADOSEZONE ❑2.CONTINUOUS INTERSTITIAL MONITORING ❑3,CONTINUOUS ATG ❑7.GROUNDWATEF. []3.MANUAL MONITORING ❑4.STATISTICAL INVENTORY RECONCILIATION ❑S.TANK TE5TIZa0 (SIR)+BMNN1.'.LTANK TESTINO ❑99.OTH$R V.TANK CLOSURE I:N>FORW'T10N'/ PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 4SS' ESTIMATED QUANTC'Y OF SUBSTANCE REMAINING 434. TANK FILLED WITH INERT MATERIAL? 4.17. WE- ❑Yea ❑ No VIFCB'hwfwrc-b(1149)-1/4 bttpq//wwwuuidoes.org Rev.02/16/00